دورية أكاديمية
أعرض في EDS

Isometry of anteromedial reconstructions mimicking the deep medial collateral ligament depends on the femoral insertion.

التفاصيل البيبلوغرافية
العنوان: Isometry of anteromedial reconstructions mimicking the deep medial collateral ligament depends on the femoral insertion.
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.)
References: Abermann E, Wierer G, Herbort M, Smigielski R, Fink C. MCL reconstruction using a flat tendon graft for anteromedial and posteromedial instability. Arthrosc Tech. 2022;11:e291–e300. https://doi.org/10.1016/j.eats.2021.10.019.
Ahn JH, Lee SH. Risk factors for knee instability after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2016;24:2936–2942. https://doi.org/10.1007/s00167-015-3568-x.
Alm L, Drenck TC, Frings J, Krause M, Korthaus A, Krukenberg A, et al. Lower failure rates and improved patient outcome due to reconstruction of the MCL and revision ACL reconstruction in chronic medial knee instability. Orthop J Sports Med. 2021;9:232596712198931. https://doi.org/10.1177/2325967121989312.
Athwal KK, Willinger L, Shinohara S, Ball S, Williams A, Amis AA. The bone attachments of the medial collateral and posterior oblique ligaments are defined anatomically and radiographically. Knee Surg Sports Traumatol Arthrosc. 2020;28:3709–3719. https://doi.org/10.1007/s00167-020-06139-6.
Ball S, Stephen JM, El‐Daou H, Williams A, Amis AA. The medial ligaments and the ACL restrain anteromedial laxity of the knee. Knee Surg Sports Traumatol Arthrosc. 2020;28:3700–3708. https://doi.org/10.1007/s00167-020-06084-4.
Bartolin PB, Shatrov J, Ball SV, Holthof SR, Williams A, Amis AA. Comparison of simplified MCL reconstructions to control valgus and anteromedial rotatory instability (AMRI): biomechanical evaluation in vitro. Orthop Proc. 2023;105‐B(Suppl_13):70. https://doi.org/10.1302/1358-992X.2023.13.070.
Bauer KL, Stannard JP. Surgical approach to the posteromedial corner: indications, technique, outcomes. Curr Rev Musculoskelet Med. 2013;6:124–131. https://doi.org/10.1007/s12178-013-9161-3.
Behrendt P, Herbst E, Robinson JR, von Negenborn L, Raschke MJ, Wermers J, et al. The control of anteromedial rotatory instability is improved with combined flat sMCL and anteromedial reconstruction. Am J Sports Med. 2022;50:2093–2101. https://doi.org/10.1177/03635465221096464.
Black AK, Schlepp C, Zapf M, Reid 3rd JB. Technique for arthroscopically assisted superficial and deep medial collateral ligament–meniscotibial ligament repair with internal brace augmentation. Arthrosc Tech. 2018;7:e1215–e1219. https://doi.org/10.1016/j.eats.2018.08.006.
Bollen S. Epidemiology of knee injuries: diagnosis and triage. Br J Sports Med. 2000;34:227‐a. https://doi.org/10.1136/bjsm.34.3.227-a.
Brantigan OC, Voshell AF. The tibial collateral ligament: its function, its bursae, and its relation to the medial meniscus. J Bone Joint Surg Am. 1943;25:121–131.
Farahmand F, Sejiavongse W, Amis AA. Quantitative study of the quadriceps muscles and trochlear groove geometry related to instability of the patellofemoral joint. J Orthop Res. 1998;16:136–143. https://doi.org/10.1002/jor.1100160123.
Feeley BT, Muller MS, Allen AA, Granchi CC, Pearle AD. Biomechanical comparison of medial collateral ligament reconstructions using computer‐assisted navigation. Am J Sports Med. 2009;37:1123–1130. https://doi.org/10.1177/0363546508331134.
Feeley BT, Muller MS, Allen AA, Granchi CC, Pearle AD. Isometry of medial collateral ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2009;17:1078–1082. https://doi.org/10.1007/s00167-009-0805-1.
Gardiner JC, Weiss JA, Rosenberg TD. Strain in the human medial collateral ligament during valgus loading of the knee. Clin Orthop Relat Res. 2001;391:266–274. https://doi.org/10.1097/00003086-200110000-00031.
Ghosh KM, Merican AM, Iranpour‐Boroujeni F, Deehan DJ, Amis AA. Length change patterns of the extensor retinaculum and the effect of total knee replacement. J Orthop Res. 2009;27:865–870. https://doi.org/10.1002/jor.20827.
Hefzy MS, Grood ES, Noyes FR. Factors affecting the region of most isometric femoral attachments. Part II: the anterior cruciate ligament. Am J Sports Med. 1989;17:208–216. https://doi.org/10.1177/036354658901700210.
Herbst E, Muhmann RJ, Raschke MJ, Katthagen JC, Oeckenpöhler S, Wermers J, et al. The anterior fibers of the superficial MCL and the ACL restrain anteromedial rotatory instability. Am J Sports Med. 2023;51:2928–2935. https://doi.org/10.1177/03635465231187043.
Jones L, Bismil Q, Alyas F, Connell D, Bell J. Persistent symptoms following non operative management in low grade MCL injury of the knee—the role of the deep MCL. Knee. 2009;16:64–68. https://doi.org/10.1016/j.knee.2008.09.002.
Kittl C, Robinson J, Raschke MJ, Olbrich A, Frank A, Glasbrenner J, et al. Medial collateral ligament reconstruction graft isometry is effected by femoral position more than tibial position. Knee Surg Sports Traumatol Arthrosc. 2021;29:3800–3808. https://doi.org/10.1007/s00167-020-06420-8.
Kwak SD, Ahmad CS, Gardner TR, Grelsamer RP, Henry JH, Blankevoort L, et al. Hamstrings and iliotibial band forces affect knee kinematics and contact pattern. J Orthop Res. 2000;18:101–108. https://doi.org/10.1002/jor.1100180115.
LaPrade RF, Ly TV, Wentorf FA, Engebretsen AH, Johansen S, Engebretsen L. The anatomy of the medial part of the knee. J Bone Joint Surg Am. 2007;89:2000–2010. https://doi.org/10.2106/00004623-200709000-00016.
Last RJ. Some anatomical details of the knee joint. J Bone Joint Surg Br. 1948;30:683–688. https://doi.org/10.1302/0301-620X.30B4.683.
Lind M, Jacobsen K, Nielsen T. Medial collateral ligament (MCL) reconstruction results in improved medial stability: results from the Danish knee ligament reconstruction registry (DKRR). Knee Surg Sports Traumatol Arthrosc. 2020;28:881–887. https://doi.org/10.1007/s00167-019-05535-x.
Liu F, Yue B, Gadikota HR, Kozanek M, Liu W, Gill TJ, et al. Morphology of the medial collateral ligament of the knee. J Orthop Surg Res. 2010;5:69. https://doi.org/10.1186/1749-799X-5-69.
Lundberg M, Messner K. Long‐term prognosis of isolated partial medial collateral ligament ruptures. A ten‐year clinical and radiographic evaluation of a prospectively observed group of patients. Am J Sports Med. 1996;24:160–163. https://doi.org/10.1177/036354659602400207.
Majewski M, Susanne H, Klaus S. Epidemiology of athletic knee injuries: a 10‐year study. Knee. 2006;13:184–188. https://doi.org/10.1016/j.knee.2006.01.005.
Marx RG, Hetsroni I. Surgical technique: medial collateral ligament reconstruction using Achilles allograft for combined knee ligament injury. Clin Orthop Relat Res. 2012;470:798–805. https://doi.org/10.1007/s11999-011-1941-8.
Miyaji N, Holthof SR, Ball SV, Williams A, Amis AA. Medial collateral ligament reconstruction for anteromedial instability of the knee: a biomechanical study in vitro. Am J Sports Med. 2022;50:1823–1831. https://doi.org/10.1177/03635465221092118.
Miyaji N, Holthof SR, Bastos RPS, Ball SV, Espregueira‐Mendes J, Williams A, et al. A triple‐strand anatomic medial collateral ligament reconstruction restores knee stability more completely than a double‐strand reconstruction: a biomechanical study in vitro. Am J Sports Med. 2022;50:1832–1842. https://doi.org/10.1177/03635465221090612.
Nakamura N, Horibe S, Toritsuka Y, Mitsuoka T, Yoshikawa H, Shino K. Acute grade III medial collateral ligament injury of the knee associated with anterior cruciate ligament tear. The usefulness of magnetic resonance imaging in determining a treatment regimen. Am J Sports Med. 2003;31:261–267. https://doi.org/10.1177/03635465030310021801.
Narvani A, Mahmud T, Lavelle J, Williams A. Injury to the proximal deep medial collateral ligament: a problematical subgroup of injuries. J Bone Joint Surg Br. 2010;92:949–953. https://doi.org/10.1302/0301-620X.92B7.23559.
Pearle AD, Shannon FJ, Granchi C, Wickiewicz TL, Warren RF. Comparison of 3‐dimensional obliquity and anisometric characteristics of anterior cruciate ligament graft positions using surgical navigation. Am J Sports Med. 2008;36:1534–1541. https://doi.org/10.1177/0363546508315536.
Robinson JR, Bull AM, Amis AA. Structural properties of the medial collateral ligament complex of the human knee. J Biomech. 2005;38:1067–1074. https://doi.org/10.1016/j.jbiomech.2004.05.034.
Robinson JR, Bull AMJ, Dew Thomas RR, Amis AA. The role of the medial collateral ligament and posteromedial capsule in controlling knee laxity. Am J Sports Med. 2006;34:1815–1823. https://doi.org/10.1177/0363546506289433.
Robinson JR, Sanchez‐Ballester J, Bull AMJ, Thomas RWM, Amis AA. The posteromedial corner revisited. An anatomical description of the passive restraining structures of the medial aspect of the human knee. J Bone Joint Surg Br. 2004;86:674–681. https://doi.org/10.1302/0301-620X.86B5.14853.
Slocum DB, Larson RL. Rotatory instability of the knee Iits pathogenesis and a clinical test to demonstrate its presence. J Bone Jt Surg. 1968;50:211–225.
Steele R. Gray's anatomy. In: Standring S, editor. The anatomical basis of clinical practice. 40th ed. Vol. 7. Churchill Livingstone Elsevier; 2009. p. 320. https://doi.org/10.1016/s1479-666x(09)80013-9.
Stephen JM, Lumpaopong P, Deehan DJ, Kader D, Amis AA. The medial patellofemoral ligament: location of femoral attachment and length change patterns resulting from anatomic and nonanatomic attachments. Am J Sports Med. 2012;40:1871–1879. https://doi.org/10.1177/0363546512449998.
Svantesson E, Hamrin Senorski E, Alentorn‐Geli E, Westin O, Sundemo D, Grassi A, et al. Increased risk of ACL revision with non‐surgical treatment of a concomitant medial collateral ligament injury: a study on 19,457 patients from the Swedish National Knee Ligament Registry. Knee Surg Sports Traumatol Arthrosc. 2019;27:2450–2459. https://doi.org/10.1007/s00167-018-5237-3.
Von Rehlingen‐Prinz F, Leiderer M, Dehoust J, Dust T, Kowald B, Frosch K‐H, et al. Association of medial collateral ligament complex injuries with anterior cruciate ligament ruptures based on posterolateral tibial plateau injuries. Sports Med Open. 2023;9:70. https://doi.org/10.1186/s40798-023-00611-6.
Warren LF, Marshall JL. The supporting structures and layers on the medial side of the knee: an anatomical analysis. J Bone Jt Surg. 1979;61:56–62. https://doi.org/10.2106/00004623-197961010-00011.
Willinger L, Balendra G, Pai V, Lee J, Mitchell A, Jones M, et al. High incidence of superficial and deep medial collateral ligament injuries in ‘isolated’ anterior cruciate ligament ruptures: a long overlooked injury. Knee Surg Sports Traumatol Arthrosc. 2022;30:167–175. https://doi.org/10.1007/s00167-021-06514-x.
Willinger L, Shinohara S, Athwal KK, Ball S, Williams A, Amis AA. Length‐change patterns of the medial collateral ligament and posterior oblique ligament in relation to their function and surgery. Knee Surg Sports Traumatol Arthrosc. 2020;28:3720–3732. https://doi.org/10.1007/s00167-020-06050-0.
Wymenga AB, Kats J‐J, Kooloos J, Hillen B. Surgical anatomy of the medial collateral ligament and the posteromedial capsule of the knee. Knee Surg Sports Traumatol Arthrosc. 2006;14:229–234. https://doi.org/10.1007/s00167-005-0682-1.
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
الوصف
تدمد:1433-7347
DOI:10.1002/ksa.12111