Biomechanical Comparison of Medial Collateral Ligament Reconstructions Using Computer-Assisted Navigation

Feeley, Brian T.; Muller, Mark S.; Allen, Answorth A.; Granchi, Carrine C.; Pearle, Andrew D.

doi:10.1177/0363546508331134

Cited by 60 publications

(51 citation statements)

References 37 publications

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“…These included donor site morbidity and nonanatomic insertion site of the MCL graft on the tibia (ie, too anterior) when preserving the insertion of a semitendinosus autograft [2,5,17,20], need for long incisions across the medial side of the knee, and relative technical complexity when using double-bundle constructs [4,9,11,17,30]. Harvesting a dynamic medial stabilizer that applies adduction moment during gait (ie, semitendinosus) in a knee with an already medial instability may pose another limitation in our opinion.…”

Section: Discussionmentioning

confidence: 99%

“…However, when MCL injuries fail to heal, reconstruction may be advised to correct chronic instability or to prevent valgus overload on a reconstructed cruciate ligament [19,26]. Several techniques have been described to reconstruct the MCL including semitendinosus autograft with preservation of the tibial insertion [2,5,17,20], allograft tissues [4,9], and double-bundle reconstructions [4,9,11,17,30]. However, some of these investigators who used a long incision across the medial aspect of the knee reported up to 20°loss of knee flexion or extension in 20% of their operations [20].…”

Section: Introductionmentioning

confidence: 99%

“…However, some of these investigators who used a long incision across the medial aspect of the knee reported up to 20°loss of knee flexion or extension in 20% of their operations [20]. In addition, keeping the semitendinosus insertion distally and using it as an MCL graft [2,5,17,20] results in a too-anterior tibial attachment (ie, the tibial insertion of the MCL should be posterior to the pes anserinus [10,18]), and double-bundle reconstructions, compared with single-bundle reconstructions, are relatively complex, corresponding to their need for multiple attachment sites on the femur as well as on the tibia, more graft tissue, and number of fixation devices (ie, screws, washers, staples, etc) required [4,9,11,17,30].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Technique: Medial Collateral Ligament Reconstruction Using Achilles Allograft for Combined Knee Ligament Injury

Marx

Hetsroni

2012

Clinical Orthopaedics &Amp; Related Research

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Background Previous approaches for medial collateral ligament (MCL) reconstruction have been associated with extensive exposure, risk of donor site morbidity with autografts, loss of motion, nonanatomic graft placement, and technical complexity with double-bundle constructs. Therefore, we implemented a technique that uses Achilles allograft, small incisions, and anatomic insertions to reconstruct the MCL. Description of Technique The MCL femoral insertion was identified, and a socket reamed over a guide pin. The Achilles bone plug was fixed in the socket and the tendon passed distally under the skin and fixed on the tibia, creating isometric reconstruction. In cases of MCL with primary ACL reconstruction, IKDCsubjective, Lysholm, and KOOS-sports scores were 91 ± 6, 92 ± 6, and 93 ± 12, respectively, and return to preinjury activity levels was achieved. In cases of MCL with revision ACL reconstruction, function was inferior, and patients did not return to their preinjury activity levels. Conclusions This technique uses allograft that provides bone-to-bone healing on the femur, requires small incisions, and creates isometric reconstruction. When performed with a cruciate reconstruction, knee stability can be restored at 2 to 5 years followup. In patients with MCL with primary ACL reconstruction, return to preinjury activity level in recreational athletes can be achieved. Patients and Methods

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Technique: Medial Collateral Ligament Reconstruction Using Achilles Allograft for Combined Knee Ligament Injury

Marx

Hetsroni

2012

Clinical Orthopaedics &Amp; Related Research

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“…Zaffagnini has used a CAS system to investigate static and dynamic laxity parameters following double-bundle ACL reconstruction [25,48,49]. These data could also be used to assess the effect of different surgical techniques on knee stability following other ligament reconstruction, including posterior cruciate ligament [50], medial collateral ligament [51], and posterolateral corner reconstructions [52]. CAS data have also been used to assess the effect of the different ACL bundles on knee kinematics in double-bundle reconstruction, but so far results are inconsistent [25,[53][54][55].…”

Section: Research Applications In Knee Ligament Surgerymentioning

confidence: 99%

Applications of computer navigation in sports medicine knee surgery: an evidence-based review

Young

Safran

Clatworthy³

2013

Curr Rev Musculoskelet Med

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Computer-assisted surgery (CAS) has been investigated in a number of sports medicine procedures in the knee. Current barriers to its widespread introduction include increased costs, duration, and invasiveness of surgery. Randomized trials on the use of CAS in anterior cruciate ligament reconstruction have failed to demonstrate a clinical benefit. Data on CAS use in high tibial osteotomy are more promising; however, long-term studies are lacking. CAS has a number of research applications in knee ligament surgery, and studies continue to explore its use in the treatment of osteochondral lesions. This article reviews the applications of CAS in sports medicine knee surgery and summarizes current literature on clinical outcomes.

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“…Most biomechanical studies on knee joints and surrounding tissue behavior are based on experiments or simplified joint models. 27,28 However, it is difficult to make direct comparisons between the reported experimental or modeling-based studies, which differ in kinematic modeling methods, test structure, mechanical properties, and bone surface geometry. Experimental kinematic analysis of joints is usually based on anatomical landmarks that limit reproducibility.…”

mentioning

confidence: 99%

The Effect of Collateral Ligament Injury on Cartilage Contact in Knee Joints Modeled With Six Degrees of Freedom

Özada

2016

J. Mech. Med. Biol.

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The purpose of this study was to create a kinematic model of the knee joint with six degrees of freedom (DOF) and evaluate the effect of medial collateral ligament (MCL) and lateral collateral ligament (LCL) rupture on cartilage contact point distribution on the tibia during flexion. We hypothesized that collateral ligament contributions vary over six DOF of knee joint articulation and affect the cartilage contact point distribution during joint articulation. The ligament contributions and distribution of joint cartilage contact points cannot be fully assessed with simplified joint models or invasive experiments. Therefore, we developed a new model in which the tibia and femur centers of mass were determined from their surface geometry, and the displacement of the moving tibia was determined from the displacements of the attached ligaments. Compared to the intact knee, the tibia with the LCL removed had higher medial translation and lower valgus rotation. The tibia with the MCL removed had higher lateral translation and higher valgus rotation than the intact knee. At 0 , 30 , and 60 , the tibia with the LCL removed had more internal rotation than the intact knee. Understanding six DOF knee joint kinematics with integration of ligament contributions and cartilage contact positions is useful for the diagnosis of ligament injuries and the design of articulating surfaces for total arthroplasty.

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Biomechanical Comparison of Medial Collateral Ligament Reconstructions Using Computer-Assisted Navigation

Cited by 60 publications

References 37 publications

Surgical Technique: Medial Collateral Ligament Reconstruction Using Achilles Allograft for Combined Knee Ligament Injury

Surgical Technique: Medial Collateral Ligament Reconstruction Using Achilles Allograft for Combined Knee Ligament Injury

Applications of computer navigation in sports medicine knee surgery: an evidence-based review

The Effect of Collateral Ligament Injury on Cartilage Contact in Knee Joints Modeled With Six Degrees of Freedom

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