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Arthroscopy. 2016 Oct;32(10):2017-2024. doi: 10.1016/j.arthro.2016.02.007. Epub 2016 May 4.

Isometric Characteristics of the Anterolateral Ligament of the Knee: A Cadaveric Navigation Study.

Author information

1
I.C.A.P.S. Sports Traumatology and Joint Surgery Institute of Saint-Raphaël, Pôle Médical des Specialités, Saint-Raphaël, France. Electronic address: imbertpierre@hotmail.com.
2
Clinique du Diaconat, ICOSS 50, Strasbourg, France.
3
Kansas City University, Kansas City, Missouri, U.S.A.
4
Générale de Santé, Hopital privé Jean Mermoz, Centre Orthopedique Santy, Lyon, France.
5
UMR Inserm 1094, Faculté de Médecine, Limoges Cedex, France.

Abstract

PURPOSE:

To measure the variations in length during flexion and internal tibial rotation of the 3 different femoral insertions of the anterolateral ligament (ALL) while maintaining a fixed tibia insertion.

METHODS:

Twelve fresh-frozen cadaver knees were analyzed using a navigation system. Maximal distance variations of the 3 different anatomic femoral insertions of the ALL were measured during knee flexion and internal tibial rotation at 20° (IR20°) and 90° (IR90°). The 3 different femoral attachments were, as published, at the center of the lateral epicondyle, distal and anterior from this position, and proximal and posterior. Each of these 3 femoral insertions was coupled to the same tibial insertion at the tibial margin, halfway between the tip of the fibular head and the prominence of the Gerdy tubercle.

RESULTS:

During IR20°, variation in the distance between paired points is not different between the proximal-posterior, epicondyle, and distal-anterior femoral insertions. These variations were statistically different during IR90° for the 3 different femoral locations. In increasing degrees of flexion, there was a length decrease between paired points observed with the proximal-posterior position. A length increase was observed for both the epicondyle location and the distal-anterior location.

CONCLUSIONS:

The ALL did not reveal an isometric behavior at any of the femoral insertion locations but had different length change patterns during knee flexion and internal tibial rotation at 90°. The proximal and posterior to epicondyle femoral position is the only position with a favorable isometry, as shown by being tight in extension and in internal rotation at 20° and then relaxed when the knee goes to flexion at 120° and during internal rotation at 90°.

CLINICAL RELEVANCE:

Clinical relevance is significant with respect to optimizing the femoral position of an ALL reconstruction.

PMID:
27157662
DOI:
10.1016/j.arthro.2016.02.007
[Indexed for MEDLINE]

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