Summary: Deep MCL reconstruction restored rotational stability to the knee throughout range of motion but did not restore valgus stability. The contemporary MCL reconstruction restore stability only near full extension.

Introduction

Injuries to the medial ligament complex result in valgus and anteromedial rotatory instability (AMRI). Historic MCL reconstruction techniques have focused on the superficial MCL in an effort to restore valgus stability while frequently ignoring the importance of the deep MCL in controlling tibial external rotation.

Objective

To assess and compare the ability of a contemporary medial collateral ligament (MCL) reconstruction and a deep MCL (dMCL) reconstruction to restore rotational and valgus stability to the knee.

Methods

Six pairs fresh-frozen cadaveric knee specimens were included and with intact soft tissue, the distal femur and tibia were potted in PVC pipes to facilitate biomechanical testing using a customized multi-axial knee activity simulator. Four states were tested: 1) intact 2) after sectioning of the sMCL and dMCL, 3) contemporary MCL reconstruction as described by LaPrade et al, and 4) dMCL reconstruction. In each state, the knees were tested under four loading conditions at varying flexion angles (0°, 20°, 40°, 60° and 90°): 8 Nm valgus torque, 5 Nm tibial external rotation torque, 90N anterior drawer, and combined 90 N anterior drawer plus 5 Nm tibial external rotation torque.

Results

Transection of the sMCL and dMCL resulted in increased laxity with the application of the valgus torque, external rotation torque, and combined anterior drawer plus external rotation at all flexion angles. dMCL reconstruction restored external rotation stability to intact levels (all p<0.05) throughout all degrees of flexion, yet dMCL reconstruction did not restore valgus stability at any flexion angle. Contemporary MCL reconstruction restored valgus and external rotation stability at 0° and 20° and valgus stability at 40° (p<0.01). In response to a combined anterior drawer plus tibial external rotation, the dMCL restored stability back to the intact level at 20° and improved stability between 40° and 90° flexion. In contrast, the contemporary MCL reconstruction did not restore stability at any degree of flexion (p>0.05).

Conclusion

Deep MCL reconstruction restored rotational stability to the knee throughout range of motion but did not restore valgus stability. The contemporary MCL reconstruction restore stability only near full extension.

Does the Anatomic Anterolateral Ligament Reconstruction Change The Anterior Stability In ACL Reconstruction? – The Cadaveric Study ePoster Presentation Nadhaporn Saengpetch, MD, THAILAND Pathomchat Pisitwattanaporn, MD, THAILAND
Biodegradable Magnesium Bone Staples Show Comparable Primary Stability In Comparison to Bone Staples Made Of Steel - A Biomechanical Comparison. ePoster Presentation Adrian Deichsel, MD, GERMANY Johannes Glasbrenner, MD, GERMANY Michael J. Raschke, MD, Prof., GERMANY Jens Wermers, Prof., GERMANY Matthias Klimek, M. Sc., GERMANY Christian Peez, MD, GERMANY Thorben Briese, MD, GERMANY Elmar Herbst, MD, PhD, GERMANY Christoph Kittl, MD, MD(res), GERMANY
Demographics, Treatment Characteristics & Outcomes of 147 Consecutive Multi Ligament Knee Injuries Undergoing Surgical Reconstruction: An Analysis of Patients Presenting to A Tertiary Institution Housing the State Trauma Unit and Perth Orthopaedics ePoster Presentation Ross Radic, MBBS FRACS (Ortho) FAOrthA, AUSTRALIA Mark Ibraheem, MBBS, AUSTRALIA Jay R. Ebert, PhD, AUSTRALIA Jessica Sim, BS, AUSTRALIA Mikhil Vijay Jain, FRCS ( Tr & Ortho ) , FeBOT, UNITED KINGDOM
Treatment Of Anteromedial Rotatory Instability Associated With Anterior Or Posterior Cruciate Ligament Injury. Cohort Study With A 2-Year Follow-Up ePoster Presentation Leonardo Addeo Ramos, MD, PhD, BRAZIL Marina Mayumi Azuma, MD, BRAZIL Gustavo Kenzo Miyashita, BRAZIL Bruno Asprino Ciancio, MD, BRAZIL Gabriel Taniguti Oliveira, MD, BRAZIL Alexandre P. Nicolini, MD, MSc, BRAZIL Jorge L. Yamashita, MD, BRAZIL
The Addition Of An Extra-Articular Anterolateral Ligament Reconstruction To An ACL Reconstruction With Hamstring Tendons Smaller Than 7 mm Produces Results Similar to Isolated ACL Reconstruction With Tendons Larger Than 8 mm In Diameter: A Matched-Pair An ePoster Presentation Camilo P. Helito, MD, PhD, Prof, BRAZIL Andre Giardino Moreira Da Silva, MD, BRAZIL Marcel F. Sobrado, MD, PHD, BRAZIL Tales Mollica Guimarães, MD, BRAZIL
Adults Undergoing Posterior Cruciate Ligament Reconstruction Have More Concomitant Multiligamentous Injury But Similar Failure Rates Compared With Adolescents ePoster Presentation Ehab M Nazzal, MD, UNITED STATES Jenna L Dvorsky, BS, MS, UNITED STATES Philipp W. Winkler , MD , AUSTRIA Gian Andrea Lucidi, MD, ITALY Bálint Zsidai, MD, SWEDEN Ian DeYoe Engler, MD, UNITED STATES Kristian Samuelsson, Prof, MD, PhD, MSc, SWEDEN James J. Irrgang, PT, PhD, FAPTA, UNITED STATES Volker Musahl, MD, Prof., UNITED STATES
An Influence of The Early Accelerated Rehabilitation After Antero Cruciate Ligament Reconstruction to the Knee Stability And Tunnels Enlargement ePoster Presentation YUSUKE SASAKI, MD, JAPAN Satomi Abe, MD, PhD, JAPAN Keisuke Matsukura, UNITED STATES
Posterior Cruciate Ligament Reconstruction with Internal Brace Augmentation. A Two-Year Minimum Cohort Study ePoster Presentation Leonardo Addeo Ramos, MD, PhD, BRAZIL Paulo Vitor Carrijo , MD, BRAZIL Gustavo Kenzo Miyashita, BRAZIL Bruno Asprino Ciancio, MD, BRAZIL Jorge L. Yamashita, MD, BRAZIL
How Body Mass Index Impacts the Complications and Outcomes of Patients with Multi-Ligamentous Knee Injuries Who Undergo Operative Repair: A Review of the Current Literature ePoster Presentation Stephanie Ferrante, BS, UNITED STATES Jeremy Adelstein, BS, UNITED STATES John Quinn, MD, UNITED STATES Parker Cavendish, BS, UNITED STATES Eric Milliron, BS, UNITED STATES Spencer E. Talentino, MD, UNITED STATES James C. Kirven, BS, UNITED STATES Charles Qin, MD, UNITED STATES Ryan H. Barnes, MD, UNITED STATES David C. Flanigan, MD, UNITED STATES Robert A Magnussen, MD, MPH, UNITED STATES Robert A. Duerr, MD, UNITED STATES
Injury Profiles in Anterior Cruciate Ligament and Posterior Cruciate Ligament Injuries ePoster Presentation Janina Kaarre, MD MSc, UNITED STATES Balint Zsidai, HUNGARY Philipp W. Winkler , MD , AUSTRIA Eric Narup, SWEDEN Alexandra Horvath , MD, MSc, SWEDEN Eleonor Svantesson, MD, SWEDEN Eric Hamrin Senorski, PT, PhD, Assoc. Prof., SWEDEN Volker Musahl, MD, Prof., UNITED STATES Kristian Samuelsson, Prof, MD, PhD, MSc, SWEDEN
Isolated Posterior Cruciate Ligament (PCL) Lesions Drives to Increased Tibio-Femoral Accelerations and Lower-Limb Compensation Strategy: In-Vivo Kinematical Analysis Through Wearable Inertial Sensors ePoster Presentation Nicola Pizza, MD, ITALY Stefano Di Paolo, Eng, PhD, ITALY Alberto Grassi, PhD, ITALY Marianna Viotto, ITALY Laura Bragonzoni, Prof., ITALY Simone Perelli, MD,PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN Stefano Zaffagnini, MD, Prof., ITALY
Bi-Cruciate Ligament (ACL-PCL) Reconstruction Associated With Medial Or Lateral Instability is at Higher Risk Of Failure: Survivorship Analysis at Long-Term Follow-Up ePoster Presentation Nicola Pizza, MD, ITALY Alberto Grassi, PhD, ITALY Anna Pagano, MD, ITALY Piero Agostinone, MD, QATAR Giacomo Dal Fabbro, MD, AUSTRALIA Gian Andrea Lucidi, MD, ITALY Marianna Viotto, ITALY Stefano Di Paolo, Eng, PhD, ITALY Stefano Zaffagnini, MD, Prof., ITALY
Knee Anteromedial Compartment Dissection: Final Results and Anterior Oblique Ligament Description ePoster Presentation Pedro Baches Jorge, PhD, BRAZIL Diego Escudeiro, MSc, BRAZIL Aires Duarte, Jr., MD, BRAZIL Luiz Gabriel B. Guglielmetti, MD, PhD, BRAZIL Marcos Vaz De Lima, MD, BRAZIL
A Systematic Review on Management and Outcome of Irreducible Knee Dislocations ePoster Presentation Shahbaz S Malik, BSc, MB BCh, MSc (Orth Engin), LLM, FRCS (Tr&Orth), UNITED KINGDOM Jessica Osan, MBBS, AUSTRALIA Randeep Singh Aujla, MBChB ChM FRCS (Tr&Orth) MFSEM, UNITED KINGDOM Nadim Aslam, FRCS(Orth), UNITED KINGDOM Peter D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA Peter B. MacDonald, MD, FRCS, Dip Sport Med, CANADA
The Three-Dimensional Osseous Knee Shape is an Accurate Reference for the Native Femoral and Tibial Attachment Sites of the Anterior and Posterior Cruciate Ligaments ePoster Presentation Timothy Voskuijl, MD, NETHERLANDS Tom M Piscaer, MD, PhD, NETHERLANDS David Hanff, MD, NETHERLANDS Duncan E. Meuffels, MD, PhD, Prof., NETHERLANDS
Biomechanics Effect Of Partial Thickness Tenotomy And Tendon Gap Closure In Harvesting Site Of Bone Patellar Tendon Autograft ePoster Presentation Nadhaporn Saengpetch, MD, THAILAND
Effect of Posterior Tibial Slope on Clinical Outcome and Survivorship after PCL Reconstruction : Minimum 10-Year Follow-up ePoster Presentation Bo Seung Bae, MD, KOREA, REPUBLIC OF Kyoung Ho Yoon, MD, PhD, Prof., KOREA, REPUBLIC OF Cheol Hee Park, MD, PhD, KOREA, REPUBLIC OF Sang-Gyun Kim, MD, PhD, KOREA, REPUBLIC OF Jae-Young Park, MD, KOREA, REPUBLIC OF Yoon-Seok Kim, MD, KOREA, REPUBLIC OF Hee Sung Lee, MD, KOREA, REPUBLIC OF Sung Hyun Hwang, MD, KOREA, REPUBLIC OF Dae Keun Suh, MD, PhD, KOREA, REPUBLIC OF

Menu

Search Filters

Deep Medial Collateral Ligament Reconstruction of the Knee Restores Rotational Stability Throughout Full Range of Motion While Contemporary MCL Reconstruction Only Does in Extension

Deep Medial Collateral Ligament Reconstruction of the Knee Restores Rotational Stability Throughout Full Range of Motion While Contemporary MCL Reconstruction Only Does in Extension

Introduction

Objective

Methods

Results

Conclusion

More 2023 Congress Knee Ligament ePosters

More 2023 ISAKOS Congress Content

Menu

Search Filters

Sign-in to ISAKOS

Deep Medial Collateral Ligament Reconstruction of the Knee Restores Rotational Stability Throughout Full Range of Motion While Contemporary MCL Reconstruction Only Does in Extension

Deep Medial Collateral Ligament Reconstruction of the Knee Restores Rotational Stability Throughout Full Range of Motion While Contemporary MCL Reconstruction Only Does in Extension

Introduction

Objective

Methods

Results

Conclusion

More 2023 ISAKOS Congress Content