Table 2.
Summary of the major findings of the included studies regarding ACL, PCL and ALL/LET.
| Study | Material model | Experimental design | Conclusion |
|---|---|---|---|
| ACL | |||
| Pena et al., 2005 [14] | MRI-based knee model | Graft stiffness and tensioning in ACLr at different knee flexion angles with three different grafts | Anterior translation of tibia was closer to that of an intact knee when BPTB graft and 60 N of pretension were used |
| Tampere et al., 2019 [29] | CT- and MRI-based knee model | Ability of the AM and TT techniques to achieve anatomical placement of femoral and tibial tunnel | AM technique provides shorter femoral tunnels and close to the anatomical footprint, while TT technique provides larger intra-articular, oval shaped hole and longer femoral tunnels |
| Abidin et al., 2021 [30] | CT-based knee model | Biomechanical effects of different types of fixators (cross-pin, interference screw, cortical button) | Cross-pin has optimum stability in terms of stress and strain at femoral site, while interference screw and cortical button provide adequate fixations for the graft |
| PCL | |||
| Ramaniraka et al., 2005 [15] | CT- and MRI-based knee model | Effects of PCLr techniques (one bundle, two bundles) on the biomechanics of the knee joint | Resected PCL should be replaced to avoid compressive forces and cartilage degeneration, while both reconstruction techniques partially restore knee biomechanics |
| Yoon et al., 2010 [31] | CT-based knee model | Biomechanical evaluation of different PCLr techniques (one bundle, two bundle and two bundle augmentation) | Double bundle augmentation is superior regarding posterior and rotational stability and present lower stresses in the graft |
| Yang et al., 2023 [32] | CT-based knee model | Influence of TTA and PTS during PCLr | Anterior open-wedge HTO (+8° PTS), as well as a large TTA of 60° can affectively weaken the “killer turn” effect during PCLr |
| Wang et al., 2023 [33] | CT- and MRI-based knee model | Ideal femoral tunnel during PCLr to reduce peak stress of the graft | Femoral tunnel 5 mm distal and 5 mm anterior to the anatomical footprint can reduce the stress on the graft, without sacrifices the posterior stability of the knee |
| ALL/LET | |||
| Risvas et al., 2024 [16] | MRI-based knee model | Interactions of ACLr combined LET on rotational stability of the knee | LET lead to a decrease in both external tibia rotation and posterior tibia translation, while larger values of tension may lead to over-constraint knee |
| Ugur et al., 2017 [34] | CT-based knee model | Reaction forces on tibia during internal rotation and ADT on both ACL and ALL | ALL is an important stabilizer against internal rotation of tibia, while ACL reflects an antagonist effect at 30° and higher flexion angles |
Abbreviations: CT, computed tomography; MRI, magnetic resonance imaging; ACL, anterior cruciate ligament; ACLr, anterior cruciate ligament reconstruction; PCL, posterior cruciate ligament; PCLr, posterior cruciate ligament reconstruction; ALL/LET, anterolateral ligament/lateral extra-articular tenodesis; AM, anteromedial; TT, transtibial; BPTB, bone-patellar tendon-bone; TTA, tibial tunnel angle; PTS, posterior tibial slope; HTO, high tibia osteotomy; ADT, anterior drawer test.