BACKGROUND Although a variety of surgical procedures for anterior talofibular ligament (ATFL) reconstruction have been reported, the effect of initial graft tension during ATFL reconstruction remains unclear. PURPOSE/HYPOTHESIS This study investigated the effects of initial graft tension on ATFL reconstruction. We hypothesized that a high degree of initial graft tension would cause abnormal kinematics and laxity. STUDY DESIGN Controlled laboratory study. METHODS Twelve cadaveric ankles were tested with a robotic system with 6 degrees of freedom to apply passive plantarflexion and dorsiflexion motions and a multidirectional load. A repeated measures experiment was designed with the intact ATFL, transected ATFL, and reconstructed ATFL at initial tension conditions of 10, 30, 50, and 70 N. The 3-dimensional path and reconstructed graft tension were simultaneously recorded, and the in situ forces of the ATFL and reconstructed graft were calculated with the principle of superposition. RESULTS Initial tension of 10 N was sufficient to imitate normal ankle kinematics and laxity, which were not significantly different when compared with those of the intact ankles. The in situ force on the reconstructed graft tended to increase as the initial tension increased. In situ force on the reconstructed graft >30 N was significantly greater than that of intact ankles. The in situ force on the ATFL was 19 N at 30° of plantarflexion. In situ forces of 21.9, 30.4, 38.2, and 46.8 N were observed at initial tensions of 10, 30, 50, and 70 N, respectively, at 30° of plantarflexion. CONCLUSION Approximate ankle kinematic patterns and sufficient laxity, even with an initial tension of 10 N, could be obtained immediately after ATFL reconstruction. Moreover, excessive initial graft tension during ATFL reconstruction caused excessive in situ force on the reconstructed graft. CLINICAL RELEVANCE This study revealed the effects of initial graft tension during ATFL reconstruction. These data suggest that excessive tension during ATFL reconstruction should be avoided to ensure restoration of normal ankle motion.

中文翻译：

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腓骨前韧带重建过程中初始移植物张力对踝关节运动学，松弛度和重建后移植物原位力的影响。

背景技术尽管已经报道了多种用于重建前胫腓韧带（ATFL）的外科手术方法，但是在ATFL重建期间初始移植物张力的影响仍然不清楚。目的/假设本研究调查了初始移植张力对ATFL重建的影响。我们假设较高的初始移植物张力会引起异常的运动学和松弛。研究设计受控的实验室研究。方法采用6个自由度的机器人系统对十二具尸体脚踝进行了测试，以施加被动足底屈，背屈运动和多方向负荷。使用完整的ATFL，横切的ATFL和在初始张力为10 N，30 N，50 N和70 N的条件下重建的ATFL设计了重复测量实验。同时记录三维路径和重建的移植物张力，并根据叠加原理计算ATFL和重建的移植物的原位力。结果10 N的初始张力足以模仿正常的脚踝运动学和松弛度，与完整的脚踝相比没有显着差异。随着初始张力的增加，在重建的移植物上的原位力倾向于增加。在> 30 N的重建移植物上的原位力明显大于完整的脚踝。在30度足底屈曲时，ATFL上的原位力为19N。在足底屈曲30°时，初始张力分别为10、30、50和70 N时，观察到的原位力分别为21.9、30.4、38.2和46.8N。结论ATFL重建后，即使立即施加10 N的初始张力，也可获得近似的脚踝运动学模式和足够的松弛度。而且，在ATFL重建期间过大的初始移植物张力在重建的移植物上引起过大的原位力。临床相关性这项研究揭示了ATFL重建过程中初始移植物张力的影响。这些数据表明，在ATFL重建期间应避免过分紧张，以确保恢复正常的踝关节运动。临床相关性这项研究揭示了ATFL重建过程中初始移植物张力的影响。这些数据表明，在ATFL重建期间应避免过分紧张，以确保恢复正常的踝关节运动。临床相关性这项研究揭示了ATFL重建过程中初始移植物张力的影响。这些数据表明，在ATFL重建期间应避免过分紧张，以确保恢复正常的踝关节运动。