Distribution of Force in the Medial Collateral Ligament Complex During Simulated Clinical Tests of Knee Stability

The American Journal of Sports Medicine
Kevin A SchaferAndrew D Pearle

Abstract

Pivot-shift injury commonly results in combined anterior cruciate ligament (ACL)/medial collateral ligament (MCL) injury, yet the contribution of the components of the MCL complex to restraining multiplanar rotatory loads forming critical subcomponents of the pivot shift is not well understood. To quantify the role of the MCL complex in restraining multiplanar rotatory loads. Controlled laboratory study. A robotic manipulator was used to apply combined valgus and internal rotation torques in a simplified model of the pivot-shift examination in 12 cadaveric knees (49 ± 11 years). Tibiofemoral kinematics were recorded with the ACL intact. Loads borne by the superficial MCL (sMCL), posterior oblique ligament (POL), deep MCL (dMCL), and ACL were determined via the principle of superposition. The POL bore about 50% of the load carried by the ACL in response to the combined torques at 5° and 15° of flexion. The POL bore load during the internal rotation component of the combined torques, while the sMCL carried load during the valgus and internal rotation phases of the simulated pivot. Load in the dMCL was always <10% of the ACL in response to combined valgus and internal rotation torques. The POL provides complementary load bearing t...Continue Reading

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Citations

Oct 28, 2016·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Dinesh SirisenaEleanor Tillett
Mar 31, 2019·Journal of Biomechanical Engineering·Ahmet ErdemirKevin B Shelburne
Sep 24, 2020·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Patricia M LutzAndrea Achtnich
Apr 12, 2020·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Guido WiererChristoph Kittl
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Aug 26, 2021·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Pedro B JorgeLuiz G Betoni Guglielmetti

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