Instrumented tibiofemoral (bone-to-bone) excursion wires were implanted
in the mid-substance of the anteromedial, central, and posterior
fiber-regions of the anterior cruciate ligament through limited anterior
and posterior arthrotomies in eight fresh knees from cadavera. The change
in the distance of linear separation between each pair of osseous
fiber-insertion sites was measured and was plotted against the angle of
flexion of the knee as the knee was cycled through a 120-degree range of
motion. Testing conditions likely to be present during intraoperative
testing for isometry were used (anterior cruciate fibers transected,
quadriceps relaxed, femur stabilized with the patient in the supine
position and the leg freely dependent, and motion of the knee induced in
neutral rotation by force applied at the level of the foot). In no instance
did the insertion-site centers of any fiber-region exhibit isometric
behavior (change in the distance of linear separation of 1.0 millimeter or
less). The least deviations from isometry (range, 1.4 to 3.1 millimeters)
were observed for the anteromedial sites, under conditions when the
gravitational dependency of the lower leg was constrained. When the leg
hung in a dependent manner during passive motion, the deviation from
isometry of the anteromedial sites of insertion increased significantly
(range, 2.8 to 5.6 millimeters). The central sites of insertion were
generally less isometric than the anteromedial sites, and the posterior
sites were the least isometric, regardless of testing conditions.