High strains near femoral insertion site of the superficial medial collateral ligament of the Knee can explain the clinical failure pattern

Abstract

The three dimensional (3D) deformation of the superficial medial collateral ligament (sMCL) of the knee might play an important role in the understanding of the biomechanics of sMCL lesions. Therefore, the strain and deformation pattern of the sMCL during the range of motion were recorded in five cadaveric knees with digital image correlation. During knee flexion, the sMCL was found to deform in the three planes. In the sagittal plane, a rotation of the proximal part of the sMCL relative to the distal part occurred with the center of this rotation being the proximal tibial insertion site of the sMCL. This deformation generated high strains near the femoral insertion site of the sMCL. These strains were significantly higher than in the other parts and were maximal at 90° with on average +3.7% of strain and can explain why most lesions in clinical practice are seen in this proximal region. The deformation also has important implications for sMCL reconstruction techniques. Only a perfect anatomic restoration of the insertion sites of the sMCL on both the proximal and distal tibial insertion sites will be able to reproduce the isometry of the sMCL and thus provide the adequate stability throughout the range of motion. The fact that knee motion between 15° and 90° caused minimal strain in the sMCL might suggest that early passive range of motion in physical therapy postoperatively should have little risk of stretching a graft out in the case of an anatomical reconstruction. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:2016-2024, 2016.

The effect of rotational degree and routine activity on the risk of collapse in transtrochanteric rotational osteotomy for osteonecrosis of the femoral head—a finite element analysis

“…6c) as previously reported [20]. This dyeing method does not alter the mechanical properties of the samples [21].…”

“…During mechanical testing, the anterior surfaces of the composite bones were recorded by a non-contact optical three-dimensional measuring system (ARAMIS 4M, GOM Corp., Germany) using DIC as previously reported [21,22]. The two digital cameras with a frame rate of 4 Hz and pan angle of 22°to medial from anterior view created a stereo view of the surface from which the 3D surface, displacements, and surface strains were calculated using the DIC program.…”

Strain Distribution in the Anterior Inferior Tibiofibular Ligament, Posterior Inferior Tibiofibular Ligament, and Interosseous Membrane Using Digital Image Correlation

“…The 3-D digital image correlation (DIC) technology used in the present study provides a new perspective on the full-field strain on the ligament with mapping that presents the mean strain in various directions and the strain distribution. Luyckx et al 12,13 have used the DIC technique for measuring strain distribution on ligaments and tendons in ex vivo experiments. The 3-D DIC method has the following advantages over traditional methods: first, it has the potential to obtain the full-field strain rather than a finite number of discrete strain measurements; second, the noncontact nature of DIC reduced the reinforcement effect to a minimum.…”

“…The strain of the ligaments was recorded by a noncontact optical 3-D strain measuring system using digital image correlation (DIC) technology with the ARAMIS 4M 75 mm (GOM, Germany), using the method previously reported. 13 Image recognition was performed by 2 digital cameras to analyze and compare the digital images acquired from the surface of a substrate instead of surface markers. By tracing a randomly applied high-contrast speckle pattern using white light, displacement and strain within the specimen was calculated from the images.…”

“…This hypothesis was tested by the use of 3-dimensional (3-D) digital image correlation (DIC) technology, which has previously been shown to generate strain maps in the high-strain regions of ligaments and similar tissues. 5,13,19,25 The aim of this study was to use 3-D DIC technology to analyze full-field strain, strain trend underfoot rotation, and subregional strain differences on syndesmotic ligaments, including the AITFL, the PITFL, and the interosseous membrane (IOM) when the ankle was rotated.…”