The role of the meniscotibial ligament in posteromedial rotational knee stability
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| 024 | 7 | 0 | |a 10.1007/s00167-015-3751-0 |2 doi |
| 035 | |a (NATIONALLICENCE)springer-10.1007/s00167-015-3751-0 | ||
| 245 | 0 | 4 | |a The role of the meniscotibial ligament in posteromedial rotational knee stability |h [Elektronische Daten] |c [A. Peltier, T. Lording, L. Maubisson, R. Ballis, P. Neyret, S. Lustig] |
| 520 | 3 | |a Purpose: Tears of the posterior horn of the medial meniscus (PHMM) are very common in the ACL-deficient knee. Specific lesions of the PHMM have been described in the setting of ACL rupture: ramp lesions and injuries to the meniscotibial ligament. There are little data available regarding the role these lesions play in knee instability. The aim of this study is to analyse the biomechanical consequences of ramp and meniscotibial ligament lesions on knee stability. Our hypothesis was that these lesions would cause increased instability in the setting of ACL rupture. Methods: A cadaveric study was undertaken: ten knees were included for analysis. The biomechanical repercussions of different meniscoligamentous injuries were studied in four stages: stage 1 involved testing the intact knee, stage 2 after transection of the ACL, stage 3 following creation of a ramp lesion, and stage 4 after detachment of the meniscotibial ligament. Four parameters were measured during the experiment: anterior tibial translation under a force of 134N, internal and external tibial rotation under a torque of 5Nm, and valgus angulation under a torque of 10Nm. Measurements were taken in four knee flexion positions: 0° or full extension, 30°, 70°, and 90° of flexion. Results: There was a statistically significant increase in anterior tibial translation for stage 2 (6.8±1.3mm, p≤0.001), stage 3 (9.4±1.3mm, p≤0.001), and stage 4 (9.3±1.3mm, p≤0.001) compared to stage 1. There was no significant difference between stage 2 and stage 3 (2.6mm, n.s.) or stage 4 (2.5mm, n.s.). We did, however, demonstrate an increase in anterior tibial translation of 2.6mm after the creation on a lesion of the PHMM compared to isolated division of the ACL, for all flexion angles combined. There was an increase in internal tibial rotation between stage 1 and stage 4 (3.2°±0.7°, p≤0.001) and between stage 2 and stage 4 (2.0°±0.7°, p=0.023). A significant difference was demonstrated for external rotation under 5Nm torque between stages 4 and 1 (2.2°±0.5°, p≤0.001) and between stages 4 and 2 (1.7°±0.5°, p=0.007) for all knee flexion angles combined. No created lesion had a significant effect on medial laxity under a 10-Nm valgus torque at any degree of knee flexion. Conclusion: Lesions of the posterior horn of the medial meniscus are frequent in cases of anterior cruciate ligament rupture. These lesions appear to play a significant role in knee stability. Ramp lesions increase the forces in the ACL, and the PHMM is a secondary restraint to anterior tibial translation. Lesions of the meniscotibial ligament may increase rotatory instability of the knee. | |
| 540 | |a European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2015 | ||
| 690 | 7 | |a Ramp lesion |2 nationallicence | |
| 690 | 7 | |a Meniscotibial ligament |2 nationallicence | |
| 690 | 7 | |a ACL |2 nationallicence | |
| 690 | 7 | |a Medial meniscus |2 nationallicence | |
| 690 | 7 | |a Knee stability |2 nationallicence | |
| 700 | 1 | |a Peltier |D A. |u Centre Albert Trillat, Orthopaedic Surgery, Croix-Rousse Hospital, Lyon, France |4 aut | |
| 700 | 1 | |a Lording |D T. |u Melbourne Orthopaedic Group, The Alfred Hospital, Melbourne, Australia |4 aut | |
| 700 | 1 | |a Maubisson |D L. |u François Rabelais University (IAE), Tours, France |4 aut | |
| 700 | 1 | |a Ballis |D R. |u Centre Albert Trillat, Orthopaedic Surgery, Croix-Rousse Hospital, Lyon, France |4 aut | |
| 700 | 1 | |a Neyret |D P. |u Centre Albert Trillat, Orthopaedic Surgery, Croix-Rousse Hospital, Lyon, France |4 aut | |
| 700 | 1 | |a Lustig |D S. |u Centre Albert Trillat, Orthopaedic Surgery, Croix-Rousse Hospital, Lyon, France |4 aut | |
| 773 | 0 | |t Knee Surgery, Sports Traumatology, Arthroscopy |d Springer Berlin Heidelberg |g 23/10(2015-10-01), 2967-2973 |x 0942-2056 |q 23:10<2967 |1 2015 |2 23 |o 167 | |
| 856 | 4 | 0 | |u https://doi.org/10.1007/s00167-015-3751-0 |q text/html |z Onlinezugriff via DOI |
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| 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/s00167-015-3751-0 |q text/html |z Onlinezugriff via DOI | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Peltier |D A. |u Centre Albert Trillat, Orthopaedic Surgery, Croix-Rousse Hospital, Lyon, France |4 aut | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Lording |D T. |u Melbourne Orthopaedic Group, The Alfred Hospital, Melbourne, Australia |4 aut | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Maubisson |D L. |u François Rabelais University (IAE), Tours, France |4 aut | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Ballis |D R. |u Centre Albert Trillat, Orthopaedic Surgery, Croix-Rousse Hospital, Lyon, France |4 aut | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Neyret |D P. |u Centre Albert Trillat, Orthopaedic Surgery, Croix-Rousse Hospital, Lyon, France |4 aut | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Lustig |D S. |u Centre Albert Trillat, Orthopaedic Surgery, Croix-Rousse Hospital, Lyon, France |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), 2967-2973 |x 0942-2056 |q 23:10<2967 |1 2015 |2 23 |o 167 | ||