Table of Contents Author Guidelines Submit a Manuscript
Computational and Mathematical Methods in Medicine
Volume 2014, Article ID 948292, 8 pages
Research Article

Influence of Bundle Diameter and Attachment Point on Kinematic Behavior in Double Bundle Anterior Cruciate Ligament Reconstruction Using Computational Model

1Department of Orthopaedic Surgery, Daejeon St. Mary’s Hospital, The Catholic University of Korea, Daejeon 301-723, Republic of Korea
2Department of Mechanical Engineering, Kyung Hee University, Yongin 446-701, Republic of Korea
3Department of Applied Mathematics, Kyung Hee University, Yongin 446-701, Republic of Korea
4Division of Biomedical Engineering, Chonbuk National University, Jeonju 561-756, Republic of Korea

Received 10 October 2013; Revised 13 December 2013; Accepted 16 December 2013; Published 5 January 2014

Academic Editor: Guang Wu

Copyright © 2014 Oh Soo Kwon et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A protocol to choose the graft diameter attachment point of each bundle has not yet been determined since they are usually dependent on a surgeon’s preference. Therefore, the influence of bundle diameters and attachment points on the kinematics of the knee joint needs to be quantitatively analyzed. A three-dimensional knee model was reconstructed with computed tomography images of a 26-year-old man. Based on the model, models of double bundle anterior cruciate ligament (ACL) reconstruction were developed. The anterior tibial translations for the anterior drawer test and the internal tibial rotation for the pivot shift test were investigated according to variation of bundle diameters and attachment points. For the model in this study, the knee kinematics after the double bundle ACL reconstruction were dependent on the attachment point and not much influenced by the bundle diameter although larger sized anterior-medial bundles provided increased stability in the knee joint. Therefore, in the clinical setting, the bundle attachment point needs to be considered prior to the bundle diameter, and the current selection method of graft diameters for both bundles appears justified.