The testing protocol included both a position- and load-controlled cyclic loading block, similar to that described in present biomechanical PCL and ACL studies.6,25,46 Position-controlled cyclic loading simulated early rehabilitation using passive range-of-motion (ROM) exercises41 and was based on the AL bundle length-knee flexion angle relationship. As this study focused on single-bundle reconstruction, which is designed to replace the stronger AL bundle, only the AL bundle was considered. According to Li et al,26 the AL bundle is at its maximum length at 90° of knee flexion and experiences a length decrease of –0.5 and 8.5 mm when the knee is flexed to 75° and 0°, respectively.

Position-controlled cyclic loading simulated full ROM from +0.5 mm (90° of knee flexion) to –8 mm (full extension). Load-controlled cyclic loading involved cyclic loading from 10 to 250 N and 500 N, respectively.

The full-construct testing setup as well as the biomechanical testing protocol including working steps 1 to 8 is illustrated in Figure 4.

(Left) Full-construct test setup. (Right) Testing protocol including points of data evaluation: force loss during position-controlled cycling (Δde), dynamic elongation250de), dynamic elongation500df), total elongation (Δbc), and stiffness during pull to failure (e). Dotted lines represent position-controlled loading; solid lines represent load-controlled loading. Post-OP, postoperative.

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