Kinematics of Different Components of the Posterolateral Corner of the Knee in the Lateral Collateral Ligament-intact State
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Kinematics of Different Components of the Posterolateral Corner of the Knee in the Lateral Collateral Ligament-intact State : A Human Cadaveric Study. / Domnick, Christoph; Frosch, Karl-Heinz; Raschke, Michael J; Vogel, Nils; Schulze, Martin; von Glahn, Mathias; Drenck, Tobias C; Herbort, Mirco.
in: ARTHROSCOPY, Jahrgang 33, Nr. 10, 10.2017, S. 1821-1830.e1.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Kinematics of Different Components of the Posterolateral Corner of the Knee in the Lateral Collateral Ligament-intact State
T2 - A Human Cadaveric Study
AU - Domnick, Christoph
AU - Frosch, Karl-Heinz
AU - Raschke, Michael J
AU - Vogel, Nils
AU - Schulze, Martin
AU - von Glahn, Mathias
AU - Drenck, Tobias C
AU - Herbort, Mirco
N1 - Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
PY - 2017/10
Y1 - 2017/10
N2 - PURPOSE: To determine the static stabilizing effects of different anatomical structures of the posterolateral corner (PLC) of the knee in the lateral collateral ligament (LCL)-intact state.METHODS: Thirteen fresh-frozen human cadaveric knees were dissected and tested using an industrial robot with an optical tracking system. Kinematics were determined for 134 N anterior/posterior loads, 10 N m valgus/varus loads, and 5 N m internal/external rotatory loads in 0°, 20°, 30°, 60°, and 90° of knee flexion. The PLC structures were dissected and consecutively released: (I) intact knee joint, (II) with released posterior cruciate ligament (PCL), (III) popliteomeniscal fibers, (IV) popliteofibular ligament, (V) arcuat and popliteotibial fibers, (VI) popliteus tendon (PLT), and (VII) LCL. Repeated-measures analysis of variance was performed with significance set at P < .05.RESULTS: After releasing the PCL, posterior tibial translation increased by 5.2 mm at 20° to 9.4 mm at 90° of joint flexion (P < .0001). A mild 1.8° varus instability was measured in 0° of flexion (P = .0017). After releasing the PLC structures, posterior tibial translation further increased by 2.9 mm at 20° to 5.9 mm at 90° of flexion (P < .05) and external rotation angle increased by 2.6° at 0° to 7.9° at 90° of flexion (P < .05, vs II). Varus stability did not decrease. Mild differences between states V and VI were found in 60° and 90° external rotation tests (2.1° and 3.1°; P < .05).CONCLUSIONS: The connecting ligaments/fibers to the PLT act as a primary static stabilizer against external rotatory loads and a secondary stabilizer against posterior tibial loads (when PCL is injured). After releasing these structures, most static stabilizing function of the intact PLT is lost. The PLC has no varus-stabilizing function in the LCL-intact knee.CLINICAL RELEVANCE: Anatomy and function of these structures for primary and secondary joint stability should be considered for clinical diagnostics and when performing surgery in the PLC.
AB - PURPOSE: To determine the static stabilizing effects of different anatomical structures of the posterolateral corner (PLC) of the knee in the lateral collateral ligament (LCL)-intact state.METHODS: Thirteen fresh-frozen human cadaveric knees were dissected and tested using an industrial robot with an optical tracking system. Kinematics were determined for 134 N anterior/posterior loads, 10 N m valgus/varus loads, and 5 N m internal/external rotatory loads in 0°, 20°, 30°, 60°, and 90° of knee flexion. The PLC structures were dissected and consecutively released: (I) intact knee joint, (II) with released posterior cruciate ligament (PCL), (III) popliteomeniscal fibers, (IV) popliteofibular ligament, (V) arcuat and popliteotibial fibers, (VI) popliteus tendon (PLT), and (VII) LCL. Repeated-measures analysis of variance was performed with significance set at P < .05.RESULTS: After releasing the PCL, posterior tibial translation increased by 5.2 mm at 20° to 9.4 mm at 90° of joint flexion (P < .0001). A mild 1.8° varus instability was measured in 0° of flexion (P = .0017). After releasing the PLC structures, posterior tibial translation further increased by 2.9 mm at 20° to 5.9 mm at 90° of flexion (P < .05) and external rotation angle increased by 2.6° at 0° to 7.9° at 90° of flexion (P < .05, vs II). Varus stability did not decrease. Mild differences between states V and VI were found in 60° and 90° external rotation tests (2.1° and 3.1°; P < .05).CONCLUSIONS: The connecting ligaments/fibers to the PLT act as a primary static stabilizer against external rotatory loads and a secondary stabilizer against posterior tibial loads (when PCL is injured). After releasing these structures, most static stabilizing function of the intact PLT is lost. The PLC has no varus-stabilizing function in the LCL-intact knee.CLINICAL RELEVANCE: Anatomy and function of these structures for primary and secondary joint stability should be considered for clinical diagnostics and when performing surgery in the PLC.
KW - Aged
KW - Aged, 80 and over
KW - Biomechanical Phenomena
KW - Cadaver
KW - Collateral Ligaments
KW - Female
KW - Humans
KW - Joint Instability
KW - Knee Joint
KW - Male
KW - Middle Aged
KW - Posterior Cruciate Ligament
KW - Range of Motion, Articular
KW - Weight-Bearing
KW - Journal Article
U2 - 10.1016/j.arthro.2017.03.035
DO - 10.1016/j.arthro.2017.03.035
M3 - SCORING: Journal article
C2 - 28615108
VL - 33
SP - 1821-1830.e1
JO - ARTHROSCOPY
JF - ARTHROSCOPY
SN - 0749-8063
IS - 10
ER -
