caa a22 4500 605458375 CHVBK 20210128100228.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00167-015-3773-7 doi (NATIONALLICENCE)springer-10.1007/s00167-015-3773-7 Double-row repair of the distal attachment of the superficial medial collateral ligament: a basic science pilot study [Elektronische Daten] [Daniel Whelan, Jeff Leiter, Treny Sasyniuk, Robert Litchfield, John Randle, Scott Hughes, Peter MacDonald] 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. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2015 Superficial medial collateral ligament nationallicence Double-row suture-bridge repair nationallicence Stress fluoroscopy nationallicence Cadaveric nationallicence Whelan Daniel University of Toronto, Toronto, ON, Canada aut Leiter Jeff Pan Am Clinic, University of Manitoba, Winnipeg, MN, Canada aut Sasyniuk Treny Sasyniuk Consulting, Vancouver, BC, Canada aut Litchfield Robert Fowler Kennedy Clinic, University of Western Ontario, London, ON, Canada aut Randle John Southlake Regional Hospital, Newmarket, ON, Canada aut Hughes Scott Pan Am Clinic, University of Manitoba, Winnipeg, MN, Canada aut MacDonald Peter Pan Am Clinic, University of Manitoba, Winnipeg, MN, Canada aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/10(2015-10-01), 2820-2824 0942-2056 23:10<2820 2015 23 167 https://doi.org/10.1007/s00167-015-3773-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-015-3773-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Whelan Daniel University of Toronto, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Leiter Jeff Pan Am Clinic, University of Manitoba, Winnipeg, MN, Canada aut NATIONALLICENCE 700 1- Sasyniuk Treny Sasyniuk Consulting, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Litchfield Robert Fowler Kennedy Clinic, University of Western Ontario, London, ON, Canada aut NATIONALLICENCE 700 1- Randle John Southlake Regional Hospital, Newmarket, ON, Canada aut NATIONALLICENCE 700 1- Hughes Scott Pan Am Clinic, University of Manitoba, Winnipeg, MN, Canada aut NATIONALLICENCE 700 1- MacDonald Peter Pan Am Clinic, University of Manitoba, Winnipeg, MN, Canada aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/10(2015-10-01), 2820-2824 0942-2056 23:10<2820 2015 23 167