Bungee effect

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In orthopedics and trauma surgery , the bungee effect is a phenomenon that can lead to instability of the knee joint after the reconstruction of a torn cruciate ligament ( cruciate ligament tear ) . The bungee effect causes the drilling channel in which the cruciate ligament graft is located to widen .

description

Schematic representation of the bungee effect. The longitudinal movement of the implant is symbolized by the red arrow.

The bungee effect mainly occurs when semitendinosus tendons are used as transplants and when they are fixed with endobuttons . This bond has - depending on the pretension - an extensibility of up to 10 percent. This extensibility enables longitudinal relative movements of the transplant in the drill channel. The bungee effect leads to tunnel widening, especially in the thigh bone canal, and thus to increased residual instability in the knee. In extreme cases, graft failure can result.

The translation of the implant, which is similar to the direction of movement of a bungee rope , gave the described effect its name.

The bungee effect is closely related to the windshield wiper effect , in which the widening of the drilling channel is caused by a waving transverse movement.

Avoidance of the bungee effect

The bungee effect can be largely prevented by several measures. Sufficient pre-tensioning of the graft on the workbench is important. Fixing the grafts close to the joints is another preventive measure.

Individual evidence

  1. ^ F. Fu and C. Ma: Anterior cruciate ligament reconstruction using quadruple hamstring. In: Operat Techn Orthop 9, 1999, pp. 264-272. doi : 10.1016 / S1048-6666 (99) 80004-4
  2. ↑ J. Höher et al .: Hamstring graft motion in the femoral tunnel when using titanium button / polyester tape fixation. In: Knee Surgery, Sports Traumatology, Arthroscopy 7, 1999, pp. 215-219. PMID 10462210
  3. ↑ A. Weiler: Anatomical "hamstring tendons" anchoring with interference screws in cruciate ligament replacement. Habilitation thesis, Humboldt University Berlin, 2002
  4. ↑ W. Attmanspacher et al.: Replacement of the anterior cruciate ligament in the TransFix® technique. In: Arthoskopie 12, 1999, pp. 305-312. doi : 10.1007 / s001420050107
  5. ^ W. Petersen and T. Zantop: The anterior cruciate ligament: Basics and current practice of operative therapy. Deutscher Ärzteverlag, 2009, ISBN 3-769-10562-1 , pp. 202f. limited preview in Google Book search

further reading

  • J. Lützner and M. Bottesi: Reconstruction of the anterior cruciate ligament. In: Trauma und Berufskrankheit 11, 2009, pp. 136–139. doi : 10.1007 / s10039-008-1469-7
  • S. Reddy et al .: Bungee cord-induced corneal lacerations correcting for myopic astigmatism. In: Journal of Cataract and Refractive Surgery 33, 2007, pp. 1339-1340. PMID 17586399
  • HH Paessler and DS Mastrokalos: Anterior cruciate ligament reconstruction using semitendinosus and gracilis tendons, bone patellar tendon, or quadriceps tendon-graft with press-fit fixation without hardware. A new and innovative procedure. In: Orthop Clin North Am 34, 2003, pp 49-64. PMID 12735201 (Review)
  • PE Rork: "Bungee cord" effect in hamstring tendon ACL reconstruction. In: Orthopedics 184, 2000, p. 184. PMID 10741360

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