Search our Database of Scientific Publications and Authors

I’m looking for a

    Details and Download Full Text PDF:
    Function and strain of the anterolateral ligament part I: biomechanical analysis.

    Knee Surg Sports Traumatol Arthrosc 2017 Apr 3;25(4):1132-1139. Epub 2017 Mar 3.
    Institute of Orthopedic Research and Biomechanics, Trauma Research Center, University of Ulm-Medical Center, Helmholtzstraße 14, 89081, Ulm, Germany.
    Purpose: Because reconstruction of the anterior cruciate ligament (ACL) in a double-bundle technique did not solve the problem of persistent rotatory laxity after surgery, new potential answers to this issue are of great interest. One of these is an extraarticular stabilization based on the rediscovery of the anterolateral ligament (ALL). Knowledge about its biomechanical function and benchmark data for an optimal reconstruction remain lacking. Therefore, the purpose of this study was to assess the function of the ALL under passive motion, anterior tibial translation and tibial rotational moments.

    Methods: Continuous passive motion (0°-120° flexion), ap-translation and static pivot shift tests were performed on eight cadaveric knees. The knees were measured in intact, ACL-resected (ACL) and ACL + ALL-resected (ALL) conditions. Ap-translation and static pivot shift under 134 N anterior shear load were determined at 0°, 30°, 60° and 90° flexion. Strain of the ALL was recorded in intact and ACLconditions.

    Results: During continuous passive motion under unloaded conditions, no significant difference in internal rotation between ACLand ALLwas observed. With an additional internal tibial torque of 1-4 Nm, internal rotation increased significantly between 60° and 120° after resection of the ALL (p ≤ 0.05). Anterior tibial translation was significantly higher at 30° in ALL(p = 0.01) and for a simulated pivot shift at 60° and 90° in ACL(p ≤ 0.01). The ALL was not strained under unloaded passive motion. Adding different internal tibial torques led to strain starting at 60° flexion (1 N m internal torque) and 15° flexion (4 N m internal torque) in intact ligaments. In ACL, significantly greater ALL strains under lower flexion angles were seen for each condition (p ≤ 0.05).

    Conclusions: This study demonstrated the ALL to be without function under passive motion and with no influence on tibial rotation. On application of extrinsic loads, the ALL had a low but significant stabilizing effect against anterior tibial shear load at low flexion angles. For this reason, it can be concluded that the ALL is supporting the ACL against internal tibial loads to a minor degree. A relationship between the ALL and the pivot shift cannot be concluded. With these results ALL-reconstruction cannot be recommended at the moment without further biomechanical investigations.
    PDF Download - Full Text Link
    ( Please be advised that this article is hosted on an external website not affiliated with PubFacts.com)
    Source Status
    http://dx.doi.org/10.1007/s00167-017-4472-3DOI ListingPossible

    Similar Publications

    An In Vitro Robotic Assessment of the Anterolateral Ligament, Part 1: Secondary Role of the Anterolateral Ligament in the Setting of an Anterior Cruciate Ligament Injury.
    Am J Sports Med 2016 Mar 18;44(3):585-92. Epub 2015 Dec 18.
    Steadman Philippon Research Institute, Vail, Colorado, USA The Steadman Clinic, Vail, Colorado, USA
    Background: Recent investigations have described the structural and functional behavior of the anterolateral ligament (ALL) of the knee through pull-apart and isolated sectioning studies. However, the secondary stabilizing role of the ALL in the setting of a complete anterior cruciate ligament (ACL) tear has not been fully defined for common simulated clinical examinations, such as the pivot-shift, anterior drawer, and internal rotation tests.

    Hypothesis: Combined sectioning of the ALL and ACL would lead to increased internal rotation and increased axial plane translation during a pivot-shift test when compared with isolated sectioning of the ACL. Read More
    An In Vitro Robotic Assessment of the Anterolateral Ligament, Part 2: Anterolateral Ligament Reconstruction Combined With Anterior Cruciate Ligament Reconstruction.
    Am J Sports Med 2016 Mar 1;44(3):593-601. Epub 2016 Feb 1.
    Steadman Philippon Research Institute, Vail, Colorado, USA The Steadman Clinic, Vail, Colorado, USA
    Background: Recent biomechanical studies have demonstrated that an extra-articular lateral knee structure, most recently referred to as the anterolateral ligament (ALL), contributes to overall rotational stability of the knee. However, the effect of anatomic ALL reconstruction (ALLR) in the setting of anterior cruciate ligament (ACL) reconstruction (ACLR) has not been biomechanically investigated or validated.

    Purpose/hypothesis: The purpose of this study was to investigate the biomechanical function of anatomic ALLR in the setting of a combined ACL and ALL injury. Read More
    The Role of the Anterolateral Structures and the ACL in Controlling Laxity of the Intact and ACL-Deficient Knee.
    Am J Sports Med 2016 Feb 10;44(2):345-54. Epub 2015 Dec 10.
    The Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, UK The Musculoskeletal Surgery Group, Department of Surgery and Cancer, Imperial College London, London, UK
    Background: Anterolateral rotatory instability (ALRI) may result from combined anterior cruciate ligament (ACL) and lateral extra-articular lesions, but the roles of the anterolateral structures remain controversial.

    Purpose: To determine the contribution of each anterolateral structure and the ACL in restraining simulated clinical laxity in both the intact and ACL-deficient knee.

    Study Design: Controlled laboratory study. Read More
    Is an Anterolateral Ligament Reconstruction Required in ACL-Reconstructed Knees With Associated Injury to the Anterolateral Structures? A Robotic Analysis of Rotational Knee Stability.
    Am J Sports Med 2017 Apr 5;45(5):1018-1027. Epub 2017 Jan 5.
    Department of Operations and Business Analytics, College of Business, University of Cincinnati, Cincinnati, Ohio, USA.
    Background: The effect of an anterolateral ligament (ALL) reconstruction on rotational knee stability and corresponding anterior cruciate ligament (ACL) graft forces using multiple knee loading conditions including the pivot-shift phenomenon has not been determined.

    Purpose: First, to determine the rotational stability and ACL graft forces provided by an anatomic bone-patellar tendon-bone ACL reconstruction in the ACL-deficient knee alone and with an associated ALL/iliotibial band (ITB) injury. Second, to determine the added rotational stabilizing effect and reduction in ACL graft forces provided by an ALL reconstruction. Read More