A Finite Element Simulation of Anterior Cruciate Ligament Reconstruction with a Patella Tendon Graft

The outcome of an anterior cruciate ligament (ACL) reconstruction surgery is dependent on several factors including the type and source of graft, pretension levels, tunnel position and orientation, knee flexion angle at the time of graft fixation, and the method of fixation. Unfortunately, few previously reported finite element (FE) based simulations of the ACL reconstruction procedure incorporate the collective changes associated with the surgery. Thus, in this study, we have employed a previously developed FE knee model [1] that was effectively cross examined against experimental data reported by other investigators. The model was modified to incorporate key surgical parameters associated with an ACL reconstruction procedure. To examine the efficacy of the ACL reconstruction simulation framework, model outputs were tested against experimentally reported tibial internal rotation under passive flexion [2]. The in-situ graft force computed under a 130 N anterior load applied at the tibia was compared to the corresponding force reported by Li and colleagues under the same loading conditions [3].