Non-operative treatment of acute medial collateral ligament lesions of the knee joint

Petermann, J.; Garrel, T. v.; Götzen, L.

doi:10.1007/bf01565459

Cited by 41 publications

(16 citation statements)

References 21 publications

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“…The maximal apparent strain during the healing period (2 week: 9.0%, 20 week: 7.2%) was the same as in the intact joint (9.3%), suggesting that the MCL was minimally strained during walking, and that other structures were important in maintaining the proximity of the medial joint surfaces. That favorable strain environment may have contributed to the spontaneous healing of the MCL in these animals, which is also seen clinically after MCL tears in the human knee (Petermann et al, 1993).…”

Section: Tablementioning

confidence: 97%

ACL/MCL transection affects knee ligament insertion distance of healing and intact ligaments during gait in the Ovine model

Tapper

Funakoshi

Hariu

et al. 2009

Journal of Biomechanics

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Section: Tablementioning

confidence: 97%

ACL/MCL transection affects knee ligament insertion distance of healing and intact ligaments during gait in the Ovine model

Tapper

Funakoshi

Hariu

et al. 2009

Journal of Biomechanics

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“…For collateral ligament injuries, scoring systems to grade severity are often based on millimetres of perceived joint opening with applied manual stress. [1][2][3] The level of resolution required for this may exceed normal levels of human judgement and account for the frequent disparity between laxity examinations and true in-vivo joint function. 4 Quantitative adjuncts, such as stress radiographs, have enabled a more objective measurement of joint space opening, but are still potentially limited by lack of standardisation of the applied load and are susceptible to limb positioning errors as a result of knee flexion or rotation.…”

Section: Introductionmentioning

confidence: 99%

Standardising the clinical assessment of coronal knee laxity

Clarke

Wilson

Wearing

et al. 2012

Proc Inst Mech Eng H

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Clinical laxity tests are used for assessing knee ligament injuries and for soft tissue balancing in total knee arthroplasty. This study reports the development and validation of a quantitative technique of assessing collateral knee laxity through accurate measurement of potential variables during routine clinical examination. The hypothesis was that standardisation of a clinical stress test would result in a repeatable range of laxity measurements. Non-invasive infrared tracking technology with kinematic registration of joint centres gave real-time measurement of both coronal and sagittal mechanical tibiofemoral alignment. Knee flexion, moment arm and magnitude of the applied force were all measured and standardised. Three clinicians then performed six knee laxity examinations on a single volunteer using a target moment of 18 Nm. Standardised laxity measurements had small standard deviations (within 1.1°) for each clinician and similar mean values between clinicians, with the valgus laxity assessment (mean of 3°) being slightly more consistent than varus (means of 4° or 5°). The manual technique of coronal knee laxity assessment was successfully quantified and standardised, leading to a narrow range of measurements (within the accuracy of the measurement system). Minimising the subjective variables of clinical examination could improve current knowledge of soft tissue knee behaviour.

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“…[1][2][3][4][5] This is in contrast to rates of nonunion seen in the medial collateral ligament (MCL), where failure of clinical healing is the exception rather than the rule. [6][7][8][9] The lack of healing seen in the ACL and other intra-articular tissues has been attributed to their relative lack of vascularity, the hostile environment of synovial fluid, 10 to alterations in the cellular metabolism after injury, 11,12 intrinsic cell deficiencies [13][14][15][16][17][18][19][20] the complex biomechanics of these tissues, and cell loss within the tissues after injury. 21 However, recent work has reported that human ACL remnants typically contain viable cells and vasculature, 22 yet there is a gap at the rupture site which remains open.…”

Section: Introductionmentioning

confidence: 99%

Collagen‐platelet rich plasma hydrogel enhances primary repair of the porcine anterior cruciate ligament

Murray¹,

Spindler²,

Abreu³

et al. 2006

Journal Orthopaedic Research

293

272

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ABSTRACT:The anterior cruciate ligament (ACL) fails to heal after suture repair. One hypothesis for this failure is the premature loss of the fibrin clot, or provisional scaffolding, between the two ligament ends in the joint environment. To test this hypothesis, a substitute provisional scaffold of collagen-platelet rich plasma (PRP) hydrogel was used to fill the ACL wound site at the time of suture repair and the structural properties of the healing ACLs evaluated 4 weeks after surgery. Bilateral ACL transections were performed in five 30-kg Yorkshire pigs and treated with suture repair. In each animal, one of the repairs was augmented with placement of a collagen-PRP hydrogel at the ACL transection site, while the contralateral knee had suture repair alone. In addition, six control knees with intact ACLs from three additional animals were used as a control group. No postoperative immobilization was used. After 4 weeks the animals underwent in vivo magnetic resonance imaging to assess the size of the healing ACL, followed by biomechanical testing to determine tensile properties. The supplementation of suture repair with a collagen-PRP hydrogel resulted in significant improvements in load at yield, maximum load, and linear stiffness at 4 weeks. We conclude that use of a stabilized provisional scaffold, such as a collagen-PRP hydrogel, to supplement primary repair of the ACL can result in improved biomechanical properties at an early time point. Further studies to determine the long-term effect of primary repair enhancement are needed. ß

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Non-operative treatment of acute medial collateral ligament lesions of the knee joint

Cited by 41 publications

References 21 publications

ACL/MCL transection affects knee ligament insertion distance of healing and intact ligaments during gait in the Ovine model

ACL/MCL transection affects knee ligament insertion distance of healing and intact ligaments during gait in the Ovine model

Standardising the clinical assessment of coronal knee laxity

Collagen‐platelet rich plasma hydrogel enhances primary repair of the porcine anterior cruciate ligament

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