scholarly journals In vivo length change of ligaments of normal knees during dynamic high flexion

2020 ◽  
Author(s):  
Kenichi Kono ◽  
Shoji Konda ◽  
Takaharu Yamazaki ◽  
Sakae Tanaka ◽  
Kazuomi Sugamoto ◽  
...  
Keyword(s):  
Medial Collateral Ligament ◽  
Sagittal Plane ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Length Change ◽  
3D Registration ◽  
Collateral Ligament ◽  
High Flexion ◽  
Leg Motion

Abstract Background Few studies compared the length change of ligaments of normal knees during dynamic activities of daily living. The aim of this study was to investigate in vivo length change of ligaments of the normal knees during high flexion. Methods Eight normal knees were investigated. Each volunteer performed squatting, kneeling, and cross-leg motions. Each sequential motion was performed under fluoroscopic surveillance in the sagittal plane. The femoral, tibial, and fibular attachment areas of the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), deep medial collateral ligament (dMCL), superficial medial collateral ligament (sMCL), and lateral collateral ligament (LCL) were determined according to osseous landmarks. After 2D/3D registration, the direct distance from the femoral attachment to the tibial or fibular attachment was measured as the ligament length. Results From 20° to 90° with flexion, the ACL was significantly shorter during cross-leg motion than during squatting. For the PCL, dMCL, sMCL, and LCL, there were no significant differences among the 3 motions. Conclusion The ACL was shorter during cross-leg motion than during squatting in mid-flexion. This suggests that the ACL is looser during cross-leg motion than during squatting. On the other hand, the length change of the PCL, MCL, and LCL did not change even though the high flexion motions were different.

scholarly journals In Vivo Length Change of Ligaments of Normal Knees During Dynamic High Flexion

2020 ◽  
Author(s):  
Kenichi Kono ◽  
Shoji Konda ◽  
Takaharu Yamazaki ◽  
Sakae Tanaka ◽  
Kazuomi Sugamoto ◽  
...  
Keyword(s):  
Medial Collateral Ligament ◽  
Sagittal Plane ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Length Change ◽  
3D Registration ◽  
Collateral Ligament ◽  
High Flexion ◽  
Leg Motion

Abstract BackgroundNo studies compared the length change of ligaments of normal knees during dynamic activities of daily living. The aim of this study was to investigate in vivo length change of ligaments of the normal knees during high flexion.MethodsEight normal knees were investigated. Each volunteer performed squatting, kneeling, and cross-leg motions. Each sequential motion was performed under fluoroscopic surveillance in the sagittal plane. The femoral, tibial, and fibular attachment areas of the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), deep medial collateral ligament (dMCL), superficial medial collateral ligament (sMCL), and lateral collateral ligament (LCL) were determined according to osseous landmarks. After 2D/3D registration, the direct distance from the femoral attachment to the tibial or fibular attachment was measured as the ligament length. ResultsFrom 20° to 90° withflexion, the ACL was significantly shorter during cross-leg motion than during squatting. For thePCL, dMCL, sMCL, and LCL, there were no significant differences among the 3 motions. ConclusionThe ACL was shorter during cross-leg motion than during squatting in mid-flexion. This suggests that the ACL is looser during cross-leg motion than during squatting. On the other hand, the length change of the PCL, MCL, and LCL did not change even though the high flexion motions were different.

scholarly journals In vivo length change of ligaments of normal knees during dynamic high flexion

2020 ◽  
Author(s):  
Kenichi Kono ◽  
Shoji Konda ◽  
Takaharu Yamazaki ◽  
Sakae Tanaka ◽  
Kazuomi Sugamoto ◽  
...  
Keyword(s):  
Medial Collateral Ligament ◽  
Sagittal Plane ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Length Change ◽  
3D Registration ◽  
Collateral Ligament ◽  
High Flexion ◽  
Leg Motion

Abstract Background Few studies compared the length change of ligaments of normal knees during dynamic activities of daily living. The aim of this study was to investigate in vivo length change of ligaments of the normal knees during high flexion. Methods Eight normal knees were investigated. Each volunteer performed squatting, kneeling, and cross-leg motions. Each sequential motion was performed under fluoroscopic surveillance in the sagittal plane. The femoral, tibial, and fibular attachment areas of the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), deep medial collateral ligament (dMCL), superficial medial collateral ligament (sMCL), and lateral collateral ligament (LCL) were determined according to osseous landmarks. After 2D/3D registration, the direct distance from the femoral attachment to the tibial or fibular attachment was measured as the ligament length. Results From 20° to 90° with flexion, the ACL was significantly shorter during cross-leg motion than during squatting. For the PCL, dMCL, sMCL, and LCL, there were no significant differences among the 3 motions. Conclusion The ACL was shorter during cross-leg motion than during squatting in mid-flexion. This suggests that the ACL is looser during cross-leg motion than during squatting. On the other hand, the length change of the PCL, MCL, and LCL did not change even though the high flexion motions were different.

Incidence of Associated Knee Lesions with Torn Anterior Cruciate Ligament: Retrospective Cohort Assessment

1998 ◽  
Vol 7 (1) ◽  
pp. 1-8 ◽  
Author(s):  
George A. Arangio ◽  
Edward W. Cohen
Keyword(s):  
Anterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Lateral Collateral Ligament ◽  
Collateral Ligament ◽  
Posterior Oblique Ligament ◽  
Anterior Cruciate Ligament Injuries ◽  
Arcuate Ligament ◽  
Anterior Cruciate

The records of 141 consecutive patients with confirmed complete anterior cruciate ligament injuries were reviewed retrospectively. One hundred and sixty-two associated injuries were divided into 25 injury complexes. Isolated injuries to the anterior cruciate ligament occurred in 40 cases (28.4%). Injuries of the medial meniscus occurred in 62 cases (38.2%), while injuries of the lateral meniscus occurred in 37 cases (22.8%). Injuries to the medial collateral ligament complex occurred in 42 cases (25.9%). Injuries to the lateral collateral ligament, posterior deep popliteus-arcuate ligament complex, and posterior cruciate ligament were found to be positively correlated (rho = .81, p = .001, and rho = .77, p = .001, N = 141, respectively). Injuries to the medial collateral ligament and the posterior oblique ligament were likewise positively correlated (rho = .45, p = .001, N = 141).

scholarly journals Tissue-specific changes in size and shape of the ligaments and tendons of the porcine knee during post-natal growth

2019 ◽  
Author(s):  
Stephanie G. Cone ◽  
Hope E. Piercy ◽  
Emily P. Lambeth ◽  
Hongyu Ru ◽  
Jorge A. Piedrahita ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Patellar Tendon ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Collateral Ligament ◽  
Cross Sectional ◽  
Anterior Cruciate

AbstractPrior studies have analyzed growth of musculoskeletal tissues between species or across body segments; however, little research has assessed the differences in similar tissues within a single joint. Here we studied changes in the length and cross-sectional area of four ligaments and tendons, (anterior cruciate ligament, patellar tendon, medial collateral ligament, lateral collateral ligament) in the tibiofemoral joint of female Yorkshire pigs through high-field magnetic resonance imaging throughout growth. Tissue lengths increased by 4-to 5-fold from birth to late adolescence across the tissues while tissue cross-sectional area increased by 10-20-fold. The anterior cruciate ligament and lateral collateral ligament showed allometric growth favoring change in length over change in cross-sectional area while the patellar tendon and medial collateral ligament grow in an isometric manner. Additionally, changes in the length and cross-sectional area of the anterior cruciate ligament did not increase as much as in the other ligaments and tendon of interest. Overall, these findings suggest that musculoskeletal soft tissue morphometry can vary within tissues of similar structure and within a single joint during post-natal growth.

Biomechanical Properties of the Stifle Joint Lateral Collateral Ligament in Dogs

1992 ◽  
Vol 05 (04) ◽  
pp. 158-162 ◽  
Author(s):  
D. Blackketter ◽  
J Harari ◽  
J. Dupuis
Keyword(s):  
Mechanical Properties ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Biomechanical Properties ◽  
Fibular Head ◽  
Joint Stability ◽  
Collateral Ligament ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint

Bone/lateral collateral ligament/bone preparations were tested and structural mechanical properties compared to properties of cranial cruciate ligament in 15 dogs. The lateral collateral ligament has sufficient stiffness to provide stifle joint stability and strength to resist acute overload following fibular head transposition.

scholarly journals IS PERCUTANEOUS MEDIAL COLLATERAL LIGAMENT (MCL) RELAXATION DURING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION A SAFE OPTION FOR GAINING ACCESS TO THE MEDIAL KNEE COMPARTMENT IN CHILDREN?

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0004
Author(s):  
John A. Schlechter ◽  
Tanner Harrah ◽  
Bryn Gornick ◽  
Benjamin Sherman
Keyword(s):  
Anterior Cruciate Ligament ◽  
Children And Adolescents ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Adult Population ◽  
Deep Infection ◽  
Patient Reported Outcome ◽  
Collateral Ligament ◽  
Patient Reported ◽  
Anterior Cruciate

Introduction: With participation in youth sports anterior cruciate ligament (ACL) injuries are a common occurrence. Nearly 70% of ACL tears in children and adolescents have an associated meniscus tear. Percutaneous medial collateral ligament (MCL) relaxation has been described as utilitarian in accessing the medial meniscus for diagnostic assessment and treatment in the adult population to increase medial compartment working space in arthroscopic surgery. The technique has not been evaluated in the pediatric population. The purpose of this study was to compare the outcomes of children and adolescents that underwent anterior cruciate ligament reconstruction (ACLR) with and without percutaneous relaxation of the medial collateral ligament (MCL) for meniscal tear management. Methods: A retrospective review was performed of patients aged 8 to 19 years old that had undergone knee arthroscopy for an (ACLR) with meniscus pathology. Those that underwent MCL relaxation were grouped together and compared to a matched cohort that did not have MCL relaxation performed. Preoperative, operative and postoperative data was analyzed. The primary measurement was obtained using a validated patient reported outcome score (Pedi-IKDC), secondary outcome measures were defined as superficial or deep infection, saphenous nerve dysesthesias, ACL graft failure and return to the operating room. Statistical analysis of the two cohorts was performed. Results: Fifty-four patients were included in the study (27 in each group) with average age 15 years (range 10-19). Average follow-up for the MCL relaxation group was 22.4 months versus 58 months for the non-MCL relaxation group. The average Pedi-IKDC score was 93.3 for the MCL relaxation group and 91.4 for the non-MCL relaxation group (p=0.34). There was no difference in patient demographics, return to the operating room (p=0.49), saphenous nerve dysesthesia (p=0.49), superficial or deep infection (p=0.32). Conclusion: ACL reconstruction in children and adolescents with MCL relaxation for the management of medial meniscal tears appears to be a safe option. Equivocal patient reported outcome scores as compared to the control group were found with no increase in post-operative complications. In children with ACL tears, appropriate diagnosis and management of medial meniscal pathology is important to maintain secondary restraint to anterior tibial translation and prevent premature graft failure. Pediatric knees can have tight medial compartments, making access difficult, potentially leading to poor visualization and iatrogenic chondral damage. Percutaneous medial collateral ligament (MCL) relaxation has been described in the adult population to increase medial compartment working space without long term sequela. We report similar findings in an all pediatric cohort.

scholarly journals Medial collateral ligament reconstruction graft isometry is effected by femoral position more than tibial position

2021 ◽  
Author(s):  
Christoph Kittl ◽  
James Robinson ◽  
Michael J. Raschke ◽  
Arne Olbrich ◽  
Andre Frank ◽  
...  
Keyword(s):  
Medial Collateral Ligament ◽  
Knee Flexion ◽  
Length Change ◽  
Collateral Ligament ◽  
Complex Behaviour ◽  
Femoral Attachment ◽  
Attachment Sites ◽  
Custom Made ◽  
Length Changes ◽  
Graft Length

Abstract Purpose The purpose of this study was to examine the length change patterns of the native medial structures of the knee and determine the effect on graft length change patterns for different tibial and femoral attachment points for previously described medial reconstructions. Methods Eight cadaveric knee specimens were prepared by removing the skin and subcutaneous fat. The sartorius fascia was divided to allow clear identification of the medial ligamentous structures. Knees were then mounted in a custom-made rig and the quadriceps muscle and the iliotibial tract were loaded, using cables and hanging weights. Threads were mounted between tibial and femoral pins positioned in the anterior, middle, and posterior parts of the attachment sites of the native superficial medial collateral ligament (sMCL) and posterior oblique ligament (POL). Pins were also placed at the attachment sites relating to two commonly used medial reconstructions (Bosworth/Lind and LaPrade). Length changes between the tibiofemoral pin combinations were measured using a rotary encoder as the knee was flexed through an arc of 0–120°. Results With knee flexion, the anterior fibres of the sMCL tightened (increased in length 7.4% ± 2.9%) whilst the posterior fibres slackened (decreased in length 8.3% ± 3.1%). All fibre regions of the POL displayed a uniform lengthening of approximately 25% between 0 and 120° knee flexion. The most isometric tibiofemoral combination was between pins placed representing the middle fibres of the sMCL (Length change = 5.4% ± 2.1% with knee flexion). The simulated sMCL reconstruction that produced the least length change was the Lind/Bosworth reconstruction with the tibial attachment at the insertion of the semitendinosus and the femoral attachment in the posterior part of the native sMCL attachment side (5.4 ± 2.2%). This appeared more isometric than using the attachment positions described for the LaPrade reconstruction (10.0 ± 4.8%). Conclusion The complex behaviour of the native MCL could not be imitated by a single point-to-point combination and surgeons should be aware that small changes in the femoral MCL graft attachment position will significantly effect graft length change patterns. Reconstructing the sMCL with a semitendinosus autograft, left attached distally to its tibial insertion, would appear to have a minimal effect on length change compared to detaching it and using the native tibial attachment site. A POL graft must always be tensioned near extension to avoid capturing the knee or graft failure.

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