Ligamentous and capsular restraints preventing straight medial and lateral laxity in intact human cadaver knees.

Grood, ES; Noyes, F R; Butler, David L.; Suntay, Wilfredo J.

doi:10.2106/00004623-198163080-00007

Cited by 510 publications

(347 citation statements)

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“…Gait abnormalities and knee instability occur after proximal fibula resection [11]. Studies in a cadaver have demonstrated that the fibular collateral ligament provides the main resistance to varus rotation at the knee [12]. Draganich et al reported increased anterior and anteroposterior translation of the knee in flexion, varusvalgus rotations at 20°flexion and several abnormalities in ground reaction forces [11].…”

Section: Discussionmentioning

confidence: 99%

Proximal fibula resection in the treatment of bone tumours

Dieckmann

Gebert

Streitbürger

et al. 2011

International Orthopaedics (SICOT)

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Background and objectives We present a large study of patients with proximal fibula resection. Moreover we describe a new classification system for tumour resection of the proximal fibula independent of the tumour differentiation. Methods In 57 patients the functional and clinical outcomes were evaluated. The follow-up ranged between six months and 22.2 years (median 7.2 years). The indication for surgery was benign tumours in ten cases and malignant tumours in 47 cases. In 13 of 45 patients, where a resection of the lateral ligament complex was done, knee instability occurred. In 32 patients a resection of the peroneal nerve with resulting peroneal palsy was necessary.

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Section: Discussionmentioning

confidence: 99%

Proximal fibula resection in the treatment of bone tumours

Dieckmann

Gebert

Streitbürger

et al. 2011

International Orthopaedics (SICOT)

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“…First, the MCL is an extremely important structure in preventing medial joint opening and external tibial rotation in the human knee (Grood et al, 1981;Monahan et al, 1984;Palmer, 1938;Seering et al, 1980;Warren et al, 1974), and approximately 40% of all severe knee injuries involve the MCL (Miyasaka et al, 1991). Second, because of its planar geometry and size, the MCL is ideal for harvesting transverse samples for direct measurement of permeability.…”

Section: Tissue Harvestmentioning

confidence: 99%

Permeability of human medial collateral ligament in compression transverse to the collagen fiber direction

Weiss

Maakestad

2006

Journal of Biomechanics

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This study quantified the apparent and intrinsic hydraulic permeability of human medial collateral ligament (MCL) under direct permeation transverse to the collagen fiber direction. A custom permeation device was built to apply flow across cylindrical samples of ligament while monitoring the resulting pressure gradient. MCLs from 5 unpaired human knees were used (donor age 55 AE 16 yr; 4 males, 1 female). Permeability measurements were performed at 3 levels of compressive pre-strain (10%, 20% and 30%) and 5 pressures (0.17, 0.34, 1.03, 1.72 and 2.76 MPa). Apparent permeability was determined from Darcy's law, while intrinsic permeability was determined from the zero-pressure crossing of the pressure-permeability curves at each compressive pre-strain. Resulting data were fit to a finite deformation constitutive law [Journal of Biomechanics 23 (1990) 1145-1156. The apparent permeability of human MCL ranged from 0:40 AE 0:05 to 8:60 AE 0:77 Â 10 À16 m 4 =N s depending on pre-strain and pressure gradient. There was a significant decrease in apparent permeability with increasing compressive pre-strain ðp ¼ 0:024Þ and pressure gradient ðpo0:001Þ; and there was a significant interaction between the effects of compressive pre-strain and pressure ðpo0:001Þ: Intrinsic permeability was 14:14 AE 0:74; 6:30 AE 2:13 and 4:29 AE 1:71 Â 10 À16 m 4 =N s for compressive pre-strains of 10%, 20% and 30%, respectively. The intrinsic permeability showed a faster decrease with increasing compressive pre-strain than that of bovine articular cartilage. These data provide a baseline for investigating the effects of disease and chemical modification on the permeability of ligament and the data should also be useful for modeling the poroelastic material behavior of ligaments. r

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“…In Warren's initial works, the superficial MCL was described as the "prime static stabilizer of the medial side of the knee" [7]. Valgus forces are resisted by the superficial MCL with the knee in the flexed position; however, it does not seem to affect medial stability at full extension based on early studies that evaluated isolated sectioning of the ligament [15,16]. More advanced biomechanical studies have recently shown the superficial MCL to provide the primary restraint to valgus force at all angles through the arc of motion at its proximal end [17•, 18•].…”

Section: Biomechanicsmentioning

confidence: 99%

“…The structures of the PMC are taut in full extension, providing stability and resistance to valgus stress in the fully extended position [15,20]. These structures begin to slacken as the knee flexes.…”

Section: Biomechanicsmentioning

confidence: 99%

Surgical approach to the posteromedial corner: indications, technique, outcomes

Bauer

Stannard

2013

Curr Rev Musculoskelet Med

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Injuries to the medial side of the knee can occur in isolation or in conjunction with multiple other ligaments about the knee. In addition, medial knee injuries can involve isolated injury to the medial collateral ligament or include the posteromedial structures of the knee. Treatment strategies differ greatly depending on injury pattern. In order to select an appropriate treatment strategy, one must accurately diagnose the injury pattern based on clinical examination and the use of appropriate imaging studies. The fundamental basis for diagnosis of a medial sided knee injury stems from understanding the static and dynamic stabilizing structures that compose the medial side of the knee. It is our aim to define the anatomic roles of medial sided structures, their importance in protecting the biomechanical stability of the knee, as well as provide indications and our preferred procedures for surgical management of these complex injuries.

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Ligamentous and capsular restraints preventing straight medial and lateral laxity in intact human cadaver knees.

Cited by 510 publications

References 0 publications

Proximal fibula resection in the treatment of bone tumours

Proximal fibula resection in the treatment of bone tumours

Permeability of human medial collateral ligament in compression transverse to the collagen fiber direction

Surgical approach to the posteromedial corner: indications, technique, outcomes

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