Importance of the different posterolateral knee static stabilizers: biomechanical study

Abstract

PURPOSEThe purpose of this study was to evaluate the relative importance of the different static stabilizers of the posterolateral corner of the knee in cadavers.METHODSTests were performed with the application of a varus and external rotation force to the knee in extension at 30 and 60 degrees of flexion using 10 cadaver knees. The forces were applied initially to an intact knee and then repeated after a selective sectioning of the ligaments into the following: section of the lateral collateral ligament; section of the lateral collateral ligament and the popliteofibular complex; and section of the lateral collateral ligament, the popliteofibular complex and the posterolateral capsule. The parameters studied were the angular deformity and stiffness when the knees were submitted to a 15 Newton-meter varus torque and a 6 Newton-meter external tibial torque. Statistical analysis was performed using the ANOVA (Analysis of Variance) and Tukey’s tests.RESULTS AND CONCLUSIONOur findings showed that the lateral collateral ligament was important in varus stability at 0, 30 and 60 degrees. The popliteofibular complex was the most important structure for external rotation stability at all angles of flexion and was also important for varus stability at 30 and 60 degrees. The posterolateral capsule was important for varus stability at 0 and 30 degrees and for external rotation stability in extension. Level of evidence: Level IV (cadaver study).

Current Concepts and Controversies in Rehabilitation After Surgery for Multiple Ligament Knee Injury

“…Repair of the medial or posterolateral corner (PLC) structures relies on suture fixation of soft tissues to bone, which must be protected from excessive forces to prevent failure [18••, 19, 29]. Repair or reconstruction of the posterior cruciate ligament (PCL) or PLC may be overly stressed by posterior translation, varus, and/or external rotation of the tibia, which can be caused by gravity or hamstring contraction [30][31][32][33]. In contrast, the anterior cruciate ligament (ACL) is typically reconstructed by placement of a graft through bone tunnels with the use of hardware that provides good graft security that should not be disrupted by early weight bearing (WB), early motion, or early exercise [34].…”

[ARTIGO RETRATADO] Revisão dos artigos sobre ortopedia recentemente publicados na imprensa científica brasileira

“…Nonetheless, better isometry was achieved in the Orthopilot group than with conventional instruments. Lasmar et al 9 evaluated the relative importance of the different static stabilizers of the posterolateral corner of the knee in cadavers by applying varus and external rotation force to the knee in extension at 30 and 60 degrees of flexion. The forces were first applied to intact knees,then repeated after selective sectioning of ligaments.…”

Estimación de par basada en electromiografía de superficie: potencial herramienta para la rehabilitación de rodilla

“…El funcionamiento de la rodilla puede afectarse principalmente por patologías de origen traumático y degenerativo, o como consecuencia de patologías de origen genético, neurológico o autoinmune (9). Actualmente, para la valoración anatomo funcional del complejo articular de la rodilla, se cuenta con distintos exámenes diagnósticos y maniobras exploratorias específicas basadas en pruebas, signos y test, los cuales requieren de la experticia del fisioterapeuta para la correcta ejecución e interpretación de las pruebas y para la valoración de la integridad del cartílago, músculos, meniscos y la estabilidad ligamentosa, entre otros (10).…”