Double-row repair of the distal attachment of the superficial medial collateral ligament: a basic science pilot study

Verfasser / Beitragende:
[Daniel Whelan, Jeff Leiter, Treny Sasyniuk, Robert Litchfield, John Randle, Scott Hughes, Peter MacDonald]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/10(2015-10-01), 2820-2824
Format:
Artikel (online)
ID: 605458375
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024 7 0 |a 10.1007/s00167-015-3773-7  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-015-3773-7 
245 0 0 |a Double-row repair of the distal attachment of the superficial medial collateral ligament: a basic science pilot study  |h [Elektronische Daten]  |c [Daniel Whelan, Jeff Leiter, Treny Sasyniuk, Robert Litchfield, John Randle, Scott Hughes, Peter MacDonald] 
520 3 |a Purpose: To describe a novel repair for tibial-sided superficial medial collateral ligament (sMCL) lesions and determine whether it restores medial joint opening to uninjured state. Agreement among experienced knee surgeons when evaluating medial joint laxity was also explored. Methods: On a series of eight human cadaveric knees, surgical elevation of the distal insertion of the sMCL was performed to replicate injury. The cut ligament was repaired using a novel double-row ‘suture-bridge' technique. Valgus stress fluoroscopic images were taken with the ligament in three states: (I)ntact, (C)ut and (R)epaired, in two positions: 0 and 20° flexion. Joint opening was measured on calibrated fluoroscopic images (in mm) based on methods described by LaPrade. Joint space opening was also estimated by three experienced knee surgeons without fluoroscopy. Results: On fluoroscopy, no significant differences in mean joint opening were observed between an intact versus repaired ligament in 0 and 20° flexion [0.5mm (95% CI −1.6, 0.73; n.s.) and 0.3mm (95% CI −1.17, 1.71; n.s.)], respectively. Agreement among surgeons was substantial (ICC=0.622, 95% CI 0.52, 0.73). Conclusion: The surgical technique adequately restored joint opening to an intact state with response to valgus stress. Agreement among surgeons when quantifying joint opening in mm was substantial. This paper addresses a technically difficult problem and provides pragmatic and practical information for surgeons who manage complicated multi-ligament knee injuries. 
540 |a European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2015 
690 7 |a Superficial medial collateral ligament  |2 nationallicence 
690 7 |a Double-row suture-bridge repair  |2 nationallicence 
690 7 |a Stress fluoroscopy  |2 nationallicence 
690 7 |a Cadaveric  |2 nationallicence 
700 1 |a Whelan  |D Daniel  |u University of Toronto, Toronto, ON, Canada  |4 aut 
700 1 |a Leiter  |D Jeff  |u Pan Am Clinic, University of Manitoba, Winnipeg, MN, Canada  |4 aut 
700 1 |a Sasyniuk  |D Treny  |u Sasyniuk Consulting, Vancouver, BC, Canada  |4 aut 
700 1 |a Litchfield  |D Robert  |u Fowler Kennedy Clinic, University of Western Ontario, London, ON, Canada  |4 aut 
700 1 |a Randle  |D John  |u Southlake Regional Hospital, Newmarket, ON, Canada  |4 aut 
700 1 |a Hughes  |D Scott  |u Pan Am Clinic, University of Manitoba, Winnipeg, MN, Canada  |4 aut 
700 1 |a MacDonald  |D Peter  |u Pan Am Clinic, University of Manitoba, Winnipeg, MN, Canada  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/10(2015-10-01), 2820-2824  |x 0942-2056  |q 23:10<2820  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-015-3773-7  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-015-3773-7  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Whelan  |D Daniel  |u University of Toronto, Toronto, ON, Canada  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Leiter  |D Jeff  |u Pan Am Clinic, University of Manitoba, Winnipeg, MN, Canada  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Sasyniuk  |D Treny  |u Sasyniuk Consulting, Vancouver, BC, Canada  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Litchfield  |D Robert  |u Fowler Kennedy Clinic, University of Western Ontario, London, ON, Canada  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Randle  |D John  |u Southlake Regional Hospital, Newmarket, ON, Canada  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Hughes  |D Scott  |u Pan Am Clinic, University of Manitoba, Winnipeg, MN, Canada  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a MacDonald  |D Peter  |u Pan Am Clinic, University of Manitoba, Winnipeg, MN, Canada  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/10(2015-10-01), 2820-2824  |x 0942-2056  |q 23:10<2820  |1 2015  |2 23  |o 167