دورية أكاديمية
Isometry of anteromedial reconstructions mimicking the deep medial collateral ligament depends on the femoral insertion.
العنوان: | Isometry of anteromedial reconstructions mimicking the deep medial collateral ligament depends on the femoral insertion. |
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المؤلفون: | Behrendt P; Department of Orthopedic and Trauma Surgery, Asklepios St. Georg, Hamburg, Germany.; Department of Anatomy, Christian-Albrechts-University, Kiel, Germany.; Department of Trauma and Orthopedic Surgery, University Medical Center Schleswig-Holstein, Kiel, Germany., Robinson JR; Knee Specialists, Bristol, UK., Herbst E; Department of Trauma, Hand and Reconstructive Surgery, University of Muenster, Muenster, Germany., Gellhaus F; Department of Anatomy, Christian-Albrechts-University, Kiel, Germany., Raschke MJ; Department of Trauma, Hand and Reconstructive Surgery, University of Muenster, Muenster, Germany., Seekamp A; Department of Trauma and Orthopedic Surgery, University Medical Center Schleswig-Holstein, Kiel, Germany., Herbort M; OCM Orthopedic Surgery Munich Clinic, Munich, Germany., Kurz B; Department of Anatomy, Christian-Albrechts-University, Kiel, Germany., Kittl C; Department of Trauma, Hand and Reconstructive Surgery, University of Muenster, Muenster, Germany. |
المصدر: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2024 Apr; Vol. 32 (4), pp. 978-986. Date of Electronic Publication: 2024 Mar 03. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Wiley Country of Publication: Germany NLM ID: 9314730 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-7347 (Electronic) Linking ISSN: 09422056 NLM ISO Abbreviation: Knee Surg Sports Traumatol Arthrosc Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2024- : [Hoboken] : Wiley Original Publication: [Heidelberg, Germany] : Springer International, c1993- |
مواضيع طبية MeSH: | Knee Injuries* , Collateral Ligaments*, Humans ; Knee Joint/surgery ; Knee Joint/physiology ; Femur/surgery ; Tibia/surgery ; Biomechanical Phenomena ; Range of Motion, Articular/physiology ; Cadaver |
مستخلص: | Purpose: This study aimed to investigate the length change patterns of the native deep medial collateral ligament (dMCL) and potential anteromedial reconstructions (AMs) that might be added to a reconstruction of the superficial MCL (sMCL) to better understand the control of anteromedial rotatory instability (AMRI). Methods: Insertion points of the dMCL and potential AM reconstructions were marked with pins (tibial) and eyelets (femoral) in 11 cadaveric knee specimens. Length changes between the pins and eyelets were then tested using threads in a validated kinematics rig with muscle loading of the quadriceps and iliotibial tract. Between 0° and 100° knee flexion, length change pattern of the anterior, middle and posterior part of the dMCL and simulated AM reconstructions were analysed using a rotary encoder. Isometry was tested using the total strain range (TSR). Results: The tibiofemoral distance of the anterior dMCL part lengthened with flexion (+12.7% at 100°), whereas the posterior part slackened with flexion (-12.9% at 100°). The middle part behaved almost isometrically (maximum length: +2.8% at 100°). Depending on the femoral position within the sMCL footprint, AM reconstructions resulted in an increase in length as the knee flexed when a more centred position was used, irrespective of the tibial attachment position. Femoral positioning in the posterior aspect of the sMCL footprint exhibited <4% length change and was slightly less tight in flexion (min TSR = 3.6 ± 1.5%), irrespective of the tibial attachment position. Conclusion: The length change behaviour of potential AM reconstructions in a functionally intact knee is mainly influenced by the position of the femoral attachment, with different tibial attachments having a minimal effect on length change. Surgeons performing AM reconstructions to control AMRI would be advised to choose a femoral graft position in the posterior part of the native sMCL attachment to optimise graft length change behaviour. Given the high frequency of MCL injuries, sufficient restoration of AMRI is essential in isolated and combined ligamentous knee injuries. Level of Evidence: There is no level of evidence as this study was an experimental laboratory study. (© 2024 The Authors. Knee Surgery, Sports Traumatology, Arthroscopy published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.) |
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معلومات مُعتمدة: | Medicinal Faculty of the Christian-Albrechts-University of Kiel |
فهرسة مساهمة: | Keywords: anteromedial rotatory instability; deep medial collateral ligament; isometry; length change; reconstruction |
تواريخ الأحداث: | Date Created: 20240303 Date Completed: 20240403 Latest Revision: 20240403 |
رمز التحديث: | 20240403 |
DOI: | 10.1002/ksa.12111 |
PMID: | 38431913 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1433-7347 |
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DOI: | 10.1002/ksa.12111 |