Biomechanical Characteristics of Human Ankle Ligaments

Foot & Ankle ◽  
1985 ◽  
Vol 6 (2) ◽  
pp. 54-58 ◽  
Author(s):  
David E. Attarian ◽  
Hugh J. McCrackin ◽  
Dennis P. DeVito ◽  
James H. McElhaney ◽  
William E. Garrett
Keyword(s):  
Constant Velocity ◽  
Soft Tissues ◽  
Maximum Load ◽  
Deltoid Ligament ◽  
Testing System ◽  
Anterior Talofibular Ligament ◽  
Ankle Ligaments ◽  
Ankle Ligament ◽  
Human Ankle ◽  
Load To Failure

The purpose of this study was to define the biomechanical characteristics of the isolated, individual bone-ligament-bone complexes of the human ankle. Twenty human ankles were dissected of all soft tissues to leave only the tibia, fibula, talus, and calcaneus with their intact anterior talofibular, calcaneofibular, posterior talofibular, and deep deltoid ligaments. Specimens were mounted and tested in a Minneapolis Testing System. Protocol consisted of cyclic loading of each isolated bone-ligament-bone preparation, followed by several constant velocity load-deflection tests at varying deflection rates, followed by a final, extremely rapid load to failure test. All ligaments exhibited nonlinearity and strain rate dependence in their load-deflection data. These properties were correlated with ligament function and trauma. The anterior talofibular ligament, the most commonly injured ankle ligament, had the lowest mean maximum load of the specimens tested, whereas the deep deltoid ligament, the least frequently completely disrupted ankle ligament, had the highest load to failure.

scholarly journals Magnetic resonance imaging in traumatic injuries of the ankle joint in children

2020 ◽  
Vol 24 (4) ◽  
pp. 266-271
Author(s):  
N. Yu. Serova ◽  
T. A. Akhadov ◽  
I. A. Melnikov ◽  
O. V. Bozhko ◽  
N. A. Semenova ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Soft Tissues ◽  
Diagnostic Value ◽  
Ankle Injuries ◽  
Deltoid Ligament ◽  
Anterior Talofibular Ligament ◽  
Mri Findings ◽  
Traumatic Injuries ◽  
Sport Activities ◽  
Bone Fragments

Introduction. Sprain of the ankle joint is one of the most common injuries in children during sport activities. Purpose. To define MRI diagnostic value in ankle joint injuries. Material and methods. 30 patients , 18 boys and 12 girls aged 8-17 ( average age 14.6 years), were enrolled into the study. 20 of them (66.7%) were 12-14 years old, 3 (10%) - < 10 years old and 7 (23.3 %) - > 14 years old. A Philips AchievadStream 3.0 Tesla scanner was used for MRI examination. Results. MRI findings showed that 17 (56.7%) patients had damage of the anterior talofibular ligament; 8 patients had avulsion of bone fragments of the lateral ankle; 9 patients (30.0%) had partial deltoid ligament injuries. Complete rupture of ligaments was rare and was seen only in two patients (6.7%). Conclusion. MRI is a method of choice in assessing ankle injuries due to high contrast of soft tissues, high resolution and multi-planar potentials. MRI is especially useful in examining soft ankle tissue structures such as tendons, ligaments, nerves and fascia, as well as in revealing hidden / subtle bone damage.

scholarly journals The Benefits of the Plastination Techniques for the Anatomo Clinical Studies of Ankle Joint Ligaments Injuries

2017 ◽  
Vol 54 (3) ◽  
pp. 487-490
Author(s):  
Alina Maria Sisu ◽  
Gheorghe Noditi ◽  
Dan Grigorescu ◽  
Sorin Floresc ◽  
Jenel Marian Patrascu ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Deltoid Ligament ◽  
Anterior Talofibular Ligament ◽  
Ligament Injuries ◽  
Calcaneofibular Ligament ◽  
Conventional Mri ◽  
Ankle Ligament ◽  
Ct And Mri ◽  
Second Degree

The present research was made by following three directions: dissection and plastination, clinical ankle joint ligament injuries and MRI and CT examination of the cases.191 cases of ankle joint ligament injuries have been studied during two years. They were examined clinically and radiologically, using CT and MRI testing. The classification of ankle sprain was based on the number of injured ligaments. Out of the 191 cases diagnosed with ligament injuries, 92 involved the anterior talofibular ligament, 54 in the calcaneofibular ligament, 40 involved the posterior talofibular ligament and 5 involved the deltoid ligament. First degree sprain involves the injury of the anterior talofibular ligament, the second degree sprain involves the injury of the anterior talofibular ligament and of the calcaneofibular ligament, and the third degree sprain involves the damaging of anterior and posterior talofibular ligaments, as well as the calcaneofibular ligament. In this paper we have diagnosed a number of 39 first degree springs, 12 of second degree springs and 41 of third degree springs. The standard X- ray examinations have a low diagnostic rate of the ankle ligament injuries. Conventional MRI has a higher accuracy in diagnosing ankle joint collateral ligaments lesions.

Simultaneous Strain Measurement With Determination of a Zero Strain Reference for the Medial and Lateral Ligaments of the Ankle

2002 ◽  
Vol 23 (9) ◽  
pp. 825-832 ◽  
Author(s):  
Satoru Ozeki ◽  
Kazunori Yasuda ◽  
Kiyoshi Kaneda ◽  
Kenichi Yamakoshi ◽  
Takahiro Yamanoi
Keyword(s):  
Plantar Flexion ◽  
Full Range ◽  
Length Change ◽  
Anterior Talofibular Ligament ◽  
Neutral Position ◽  
Calcaneofibular Ligament ◽  
Ankle Ligaments ◽  
Ankle Motion ◽  
Ankle Ligament ◽  
Fresh Frozen

The strain changes of the central part of the anterior talofibular ligament (ATFL), the posterior talofibular ligament (PTFL), the calcaneofibular ligament (CFL), and the tibiocalcaneal ligament (TCL) were measured simultaneously for a full range of ankle motion. Twelve fresh frozen amputated ankles were used. To measure the strain changes of the ligaments, a Galium-lndium-filled silastic strain transducer was implanted in the center of each ligament. The zero strain reference was determined immediately after the measurement of strain changes in five of the 12 ankles by tensile testing of each bone-ligament-bone preparation. The maximum strain change of the ATFL, the PTFL, the CFL and the TFL were 7.9%, 5.9%, 5.3% and 5.2%, respectively. The ATFL was elongated in plantar flexion and shortened in dorsiflexion. The PTFL and the CFL were shortened in plantar flexion and elongated in dorsiflexion. The TCL was the longest around the neutral position and became shorter in planter flexion and dorsiflexion. The results showed that the ATFL was taut in plantar flexion over 16.2°, the PTFL and the CFL were taut in dorsiflexion over 18° and 17.8° respectively, and the TCL was taut between 9.5° of dorsiflexion and 9.5° of plantar flexion. The length change pattern was different among the ankle ligaments, although there was only a slight difference between that of the PTFL and the CFL. This study provides fundamental data useful in studying ankle ligament reconstruction.

Quantitative Analysis of Deltoid Ligament Degradation in Patients With Chronic Ankle Instability Using Computed Tomographic Images

2021 ◽  
pp. 107110072199707
Author(s):  
Yasunari Ikuta ◽  
Tomoyuki Nakasa ◽  
Junichi Sumii ◽  
Akinori Nekomoto ◽  
Nobuo Adachi
Keyword(s):  
Ankle Instability ◽  
Ct Images ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Deltoid Ligament ◽  
Anterior Talofibular Ligament ◽  
Mri Findings ◽  
Calcaneofibular Ligament ◽  
Level Of Evidence ◽  
Strong Negative Correlation

Background: Rotational ankle instability (RAI) is associated with the faster onset of severe ankle osteoarthritis via dysfunction of the anterior talofibular ligament, calcaneofibular ligament, and deltoid ligament. No specific clinical examination is available for RAI, and diagnostic imaging has limitations in evaluating ligament degradation. This study investigated the deltoid ligament degeneration using Hounsfield unit (HU) values on computed tomography (CT) images. Methods: Patients were enrolled in this retrospective analysis if they had undergone magnetic resonance imaging (MRI) and CT scans of the ankle. The chronic ankle instability (CAI) group comprised 20 ankles with CAI (9 men, 11 women; mean age, 28.7 years) and the control group comprised 28 ankles (16 men, 12 women, mean age, 41.3 years). The average HU values of the deep posterior tibiotalar ligament (dPTL) that constitutes the deltoid ligament were measured on coronal CT images, and MRI results were used as a reference. All patients were subdivided based on the MRI findings of dPTL injury such as fascicular disruption, irregularity, and the loss of striation. Results: A strong negative correlation was identified between age and HU values for all patients (Spearman ρ = −0.63; P < .001). The mean HU values of the dPTL for participants aged <60 years were 81.0 HU for the control group (21 ankles) and 69.5 HU for the CAI group ( P = .0075). No significant differences in the HU values were observed for the dPTL among the MRI subgroups. Conclusion: In addition to the conventional imaging examination such as stress radiographs and MRI, HU measurements of CT images could be useful for quantitatively and noninvasively evaluating degenerative changes in the deltoid ligament for CAI patients to assist the diagnosis of RAI. Level of Evidence: Level III. case-control study.

Maximum load to failure and tensile displacement of an all-suture glenoid anchor compared with a screw-in glenoid anchor

2013 ◽  
Vol 24 (2) ◽  
pp. 357-364 ◽  
Author(s):  
Tim Dwyer ◽  
Thomas L. Willett ◽  
Andrew P. Dold ◽  
Massimo Petrera ◽  
David Wasserstein ◽  
...  
Keyword(s):  
Maximum Load ◽  
Load To Failure

scholarly journals Comparison of Ordinary Cannulated Compression Screw and Double-Head Cannulated Compression Screw Fixation in Vertical Femoral Neck Fractures

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Yuelei Zhang ◽  
Chao Yan ◽  
Lecheng Zhang ◽  
Wei Zhang ◽  
Gang Wang
Keyword(s):  
Femoral Neck ◽  
Maximum Load ◽  
Femoral Neck Fractures ◽  
Axial Stiffness ◽  
Screw Loosening ◽  
Compression Screw ◽  
Fixation Failure ◽  
Fracture Displacement ◽  
Load To Failure ◽  
Double Head

Background. The treatment of vertical femoral neck fractures in young patients remains a challenge. This study is aimed at comparing ordinary cannulated compression screw (OCCS) and double-head cannulated compression screw (DhCCS) fixation in vertical femoral neck fractures both clinically and biomechanically. Materials and Methods. Clinically, the radiographs of 81 patients with Pauwel’s III femoral neck fractures, including 54 fractures fixed with three parallel OCCSs and 27 fractures fixed with three parallel DhCCSs, were reviewed retrospectively. Complications consisting of fixation failure (screw loosening, obvious fracture displacement, varus deformity, or femoral neck shortening), bony nonunion, and avascular necrosis (AVN) were determined. Biomechanically, twenty synthetic femur models of vertical femoral fractures with an 80° Pauwel’s angle were divided into two groups and subsequently fixed with three parallel OCCSs or DhCCSs. All specimens were tested for axial stiffness, load to 5 mm displacement, and a maximum load to failure with a loading rate of 2 mm/min. Results. Clinically, 22 fractures in the OCCS group experienced fixation failure, including 19 screw loosening, 18 femoral neck shortening, 14 varus deformities, and 8 obvious fracture displacements, whereas only 4 fractures experienced fixation failure in the DhCCS group, including 3 screw loosening, 3 femoral neck shortening, 3 varus deformities, and 1 obvious fracture displacement. Additionally, 11 fractures in the OCCS group exhibited nonunion, whereas only 3 in the DhCCS group exhibited nonunion. Nine fractures with AVN were noted in the OCCS group, whereas only 1 was observed in the DhCCS group. Biomechanically, the axial stiffness of the DhCCS group was greater than that of the OCCS group ( 154.9 ± 6.81 vs. 128.1 ± 7.41  N/mm), and the load to 5 mm displacement was also significantly greater in the DhCCS group ( 646.1 ± 25.87 vs. 475.8 ± 21.46  N). Moreover, the maximum load to failure in the DhCCS group exhibited significant advantages compared with that of the OCCS group ( 1148 ± 39.47 vs. 795.9 ± 51.39  N). Conclusion. Our results suggested that using three DhCCSs improved the outcome of vertical femoral neck fractures compared to three OCCSs, offering a new choice for the treatment of femoral neck fracture.

The Addition of a Krackow Rip Stop Suture Augment After Achilles Tendon Debridement for Insertional Achilles Tendinopathy: A Biomechanical Study

2021 ◽  
pp. 193864002110336
Author(s):  
LT Thomas J. Kelsey ◽  
LT Kyle W. Mombell ◽  
CDR Todd A. Fellars
Keyword(s):  
Achilles Tendon ◽  
Suture Anchor ◽  
Maximum Load ◽  
Achilles Tendinopathy ◽  
Catastrophic Failure ◽  
Double Row ◽  
Average Load ◽  
Load To Failure ◽  
Insertional Achilles Tendinopathy ◽  
Repair Techniques

Background In the operative treatment of insertional Achilles tendinopathy, the Achilles tendon is often released from its insertion to allow for adequate debridement of pathologic tissue. The use of a double row suture anchor construct has become increasingly favorable among surgeons after Achilles tendon debridement. This study hypothesized that the addition of a Krackow rip stop suture augment to the double row suture anchor construct would increase the repair’s maximum load to failure. A biomechanically stronger repair would potentially decrease the risk of catastrophic failure with early weight-bearing or accidental forced dorsiflexion after operative management for insertional Achilles tendinopathy. Methods Fourteen cadaveric specimens were used to compare the 2 repair techniques. Achilles tendons were debrided and repaired using either a double row suture anchor with and without the additional Krackow rip stop suture augment. The 2 repair techniques were compared using an axial-torsion testing system to measure average load to failure. Results The average load to failure for the double row suture anchor repair alone was 152.00 N. The average load to failure for the tendons with the double row suture anchor with the Krackow rip stop augment was 383.08 N. An independent-samples Mann-Whitney U-test was conducted and the suture anchor plus Krackow augment group had a significantly higher load to failure ( P = .011, Mann-Whitney U = 5.00, n1 = n2 = 7, P < .05, 2-tailed). Conclusion This study confirmed that the addition of a Krakow rip stop augment to the double row suture anchor is able to increase the maximum load to failure when compared to the double row suture anchor alone. These results suggest the potential of this added technique to decrease the risk of catastrophic failure.

Zoledronic Acid Substantially Improves Bone Microarchitecture and Biomechanical Properties After Rotator Cuff Repair in a Rodent Chronic Defect Model

2020 ◽  
Vol 48 (9) ◽  
pp. 2151-2160
Author(s):  
Jakob E. Schanda ◽  
Claudia Keibl ◽  
Patrick Heimel ◽  
Xavier Monforte ◽  
Stefan Tangl ◽  
...  
Keyword(s):  
Zoledronic Acid ◽  
Rotator Cuff ◽  
Humeral Head ◽  
Bone Microarchitecture ◽  
Intervention Group ◽  
Maximum Load ◽  
Biomechanical Properties ◽  
Rotator Cuff Tears ◽  
Mineral Density ◽  
Load To Failure

Background: Bone mineral density at the humeral head is reduced in patients with chronic rotator cuff tears. Bone loss in the humeral head is associated with repair failure after rotator cuff reconstruction. Bisphosphonates (eg, zoledronic acid) increase bone mineral density. Hypothesis: Zoledronic acid improves bone mineral density of the humeral head and biomechanical properties of the enthesis after reconstruction of chronic rotator cuff tears in rats. Study Design: Controlled laboratory study. Methods: A total of 32 male Sprague-Dawley rats underwent unilateral (left) supraspinatus tenotomy with delayed transosseous rotator cuff reconstruction after 3 weeks. All rats were sacrificed 8 weeks after rotator cuff repair. Animals were randomly assigned to 1 of 2 groups. At 1 day after rotator cuff reconstruction, the intervention group was treated with a single subcutaneous dose of zoledronic acid at 100 µg/kg bodyweight, and the control group received 1 mL of subcutaneous saline solution. In 12 animals of each group, micro–computed tomography scans of both shoulders were performed as well as biomechanical testing of the supraspinatus enthesis of both sides. In 4 animals of each group, histological analyses were conducted. Results: In the intervention group, bone volume fraction (bone volume/total volume [BV/TV]) of the operated side was higher at the lateral humeral head ( P = .005) and the medial humeral head ( P = .010) compared with the control group. Trabecular number on the operated side was higher at the lateral humeral head ( P = .004) and the medial humeral head ( P = .001) in the intervention group. Maximum load to failure rates on the operated side were higher in the intervention group ( P < .001). Cortical thickness positively correlated with higher maximum load to failure rates in the intervention group ( r = 0.69; P = .026). Histological assessment revealed increased bone formation in the intervention group. Conclusion: Single-dose therapy of zoledronic acid provided an improvement of bone microarchitecture at the humeral head as well as an increase of maximum load to failure rates after transosseous reconstruction of chronic rotator cuff lesions in rats. Clinical Relevance: Zoledronic acid improves bone microarchitecture as well as biomechanical properties after reconstruction of chronic rotator cuff tears in rodents. These results need to be verified in clinical investigations.

scholarly journals Novel implant-free loop Tenodesis vs. simple Tenotomy of the long biceps tendon - a biomechanical investigation

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Maximilian Kerschbaum ◽  
Andreas Voss ◽  
Christian Pfeifer ◽  
Isabella Weiss ◽  
Agnes Mayr ◽  
...  
Keyword(s):  
Biceps Tendon ◽  
Maximum Load ◽  
Study Groups ◽  
Displacement Curve ◽  
The Novel ◽  
Shoulder Joints ◽  
Biomechanical Investigation ◽  
Mode Of Failure ◽  
Load To Failure ◽  
Group A

Abstract Background Simple tenotomy and anchor tenodesis are commonly used in treatment of long biceps tendon (LHB) pathologies. The tenotomy can result in biceps distalization or cosmetic deformities. A novel loop Tenodesis Technique (LTD) could prevent a distalization of the biceps muscle without the risk of implant associated complications. The purpose of this study was to investigate the biomechanical aspects of the novel LTD compared to a standard tenotomy of the LHB. It has been hypothesized that the novel technique will show biomechanical superiority in terms of resistance and distalization. Methods Seven paired adult human cadaveric shoulder joints were assigned to one of the two study groups: Loop tenodesis (LTD); simple tenotomy (STT). In both groups load-to-failure testing was performed. The load-displacement curve was used to determine the maximum load (N), the degree of distalization of the LHB (mm) and the stiffness (N/mm). Additionally, the mode of failure was registered. Results The LTD group achieved a significantly higher ultimate load to failure (LTD: 50.5 ± 12.5 N vs. STT: 6.6 ± 3.9 N; p = 0.001). Significantly less distalization of the tendon could be detected for the LTD group (LTD: 8 ± 2.3 mm vs. STT: 22.4 ± 2.4 mm; p = 0.001). Stiffness was 7.4 ± 3.9 N/mm for the LTD group and 0.23 ± 0.16 N/mm for the STT group (p = 0.001). In all specimens of the LTD group a tendon rupture was found as mode of failure, while the STT group failed because of pulling out the LHB through the bicipital groove. Conclusion The novel loop Tenodesis Technique shows biomechanically higher stability as well as less distalization compared to a simple tenotomy of the long biceps tendon.

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