Lateral tenodesis procedures increase lateral compartment pressures more than anterolateral ligament reconstruction, when performed in combination with ACL reconstruction: a pilot biomechanical study
| Autor: | Sven Putnis, Brett Fritsch, Danè Dabirrahmani, Joseph Cadman, Thomas Neri, Richard Appleyard, Brian M. Devitt, Samuel Grasso, Aaron Beach, David Parker, Takeshi Oshima, Myles Coolican |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Joint Instability
Anterolateral ligament Knee Joint Rotation Anterior cruciate ligament reconstruction medicine.medical_treatment Tenodesis Pilot Projects Osteoarthritis 03 medical and health sciences 0302 clinical medicine Cadaver Pressure medicine Humans Orthopedics and Sports Medicine Range of Motion Articular Orthodontics Lateral meniscus 030222 orthopedics Anterior Cruciate Ligament Reconstruction business.industry Anterior Cruciate Ligament Injuries Compartment (ship) Biomechanics 030229 sport sciences medicine.disease Biomechanical Phenomena medicine.anatomical_structure Ligaments Articular Surgery Cadaveric spasm business Contact pressure |
| Zdroj: | Journal of ISAKOS. 6:66-73 |
| ISSN: | 2059-7754 |
| DOI: | 10.1136/jisakos-2019-000368 |
| Popis: | Given the common occurrence of residual laxity and re-injury post anterior cruciate ligament reconstruction (ACLR), additional anterolateral procedures are increasingly used in combination with an ACLR. Despite the perception that there is a risk of over-constraining the lateral tibiofemoral (LTF) compartment, potentially leading to osteoarthritis, assessment on their effect on intra-articular compartment pressures is still lacking. Our objective was therefore, through a pilot biomechanical study, to compare LTF contact pressures after the most commonly used anterolateral procedures.A controlled laboratory pilot study was performed using 4 fresh-frozen cadaveric whole lower limbs. Through 0° to 90° of flexion, LTF contact pressures were measured with a Tekscan sensor, located under the lateral meniscus. Knee kinematics were obtained in 3 conditions of rotation (NR: neutral, ER: external and IR: internal rotation) to record the position of the knees for each loading condition. A Motion Analysis system with a coordinate system based on CT scans 3D bone modelling was used. After an ACLR, defined as the reference baseline, 5 anterolateral procedures were compared: anterolateral ligament reconstruction (ALLR), modified Ellison, deep Lemaire, superficial Lemaire and modified MacIntosh procedures. The last 3 procedures were randomised. For each procedure, the graft was fixed in NR at 30° of flexion and with a tension of 20 N.Compared with isolated ACLR, addition of either ALLR or modified Ellison procedure did not increased the overall LTF contact pressure (all p0.05) through the full range of flexion for the IR condition. Conversely, deep Lemaire, superficial Lemaire and modified MacIntosh procedure (all p0.05) did increase the overall LTF contact pressure compared with ACLR in IR. No significant difference was observed in ER and NR conditions.This pilot study, comparing the main anterolateral procedures, revealed that addition of either ALLR or modified Ellison procedure did not change the overall contact pressure in the LTF compartment through 0° to 90° of knee flexion. In contrast, the deep and superficial Lemaire, and modified MacIntosh procedures significantly increased overall LTF contact pressures when the knee was internally rotated. |
| Databáze: | OpenAIRE |
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