Anterior cruciate ligament reconstruction with a quadrupled hamstrings tendon autograft does not restore tibial rotation to normative levels during landing from a jump and subsequent pivoting

V. Chouliaras, S. Ristanis, C. Moraiti, V. Tzimas, N. Stergiou, A. D. Georgoulis

Research output: Contribution to journalArticle

17 Scopus citations


Aim. Recent research suggested that the anterior curciate liga-ment (ACL) reconstruction does not restore tibial rotation to normal levels when a bone patellar tendon bone (BPTB) graft is used during high demanding activities. Our goal was to deter-mine if the usage of an alternative graft, as the quadrupled semitendinosus-gracilis (ST/G), restore tibial rotation to nor-mal values in a population of athletically active individuals while performing a usual for their sport activity. Methods. Eleven subjects, all reconstructed with an ST/G graft, were assessed in vivo, 9 months postoperatively, while they jumped off a 40 cm platform, landed on the ground and sub-sequently pivoted at 90 degrees. The evaluation period was identified from initial foot contact with the ground, included the pivoting of the ipsilateral leg, and was completed upon touch-down of the contralateral leg. By that time the patients had already returned to their sports activities. Results. The maximum range of motion of the tibial rotation for the pivoting leg, during the evaluation period was found signi-ficantly (P=0.0001) larger in the reconstructed leg as compared to the intact contralateral, although both clinical and arthro-meter assessments revealed restoration of anterior translation. Conclusion. It was concluded that ACL reconstruction with an ST/G graft does not restore tibial rotation to normal levels during this high demanding activity. It seems that new surgical techniques are needed to better replicate the actual anatomy and function of the natural ACL in order to address this problem.

Original languageEnglish (US)
Pages (from-to)64-70
Number of pages7
JournalJournal of Sports Medicine and Physical Fitness
Issue number1
Publication statusPublished - Mar 1 2009



  • Anterior cruciate ligament
  • Bone-patellar tendon-bone graft
  • Gait
  • Tibia

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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