Evidence map›Paper›PMID 39370699›Full record

ArticleThe American journal of sports medicine2024

Anterior Slope-Modifying Osteotomies Alter the Length Change Behavior of the Superficial Medial Collateral Ligament: A Biomechanical Study.

Christian Peez, Carla Ottens, Adrian Deichsel, Michael J Raschke, Thorben Briese, Elmar Herbst, James R Robinson, Christoph Kittl

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Article in The American journal of sports medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Christian PeezDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
Carla OttensDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
Adrian DeichselDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.ORCID 0000-0003-1643-5992
Michael J RaschkeDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
Thorben BrieseDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
Elmar HerbstDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
James R RobinsonKnee Specialists, Bristol, United Kingdom.
Christoph KittlDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIncreased tibial slope has been shown to lead to higher rates of anterior cruciate ligament graft failure. A slope-decreasing osteotomy can reduce in situ anterior cruciate ligament force and may mitigate this risk. However, how this procedure may affect the length change behavior of the medial ligamentous structures is unknown. PURPOSE/HYPOTHESIS: The purpose of this study was to examine the effect of anterior slope-modifying osteotomies on the medial ligamentous structures. It was hypothesized that (1) decreasing the tibial slope would lead to shortening of the superficial medial collateral ligament (sMCL), (2) while the fibers of the posterior oblique ligament (POL) would be unaffected. STUDY

designDescriptive laboratory study.

methodsEight fresh-frozen cadaveric knee specimens underwent anatomic dissection to precisely identify the medial ligamentous structures. The knees were mounted in a custom-made kinematics rig with the quadriceps muscle and iliotibial tract loaded. An anterior slope-modifying osteotomy was performed and fixed using an external fixator, which allowed modification of the wedge height between -15 and +10 mm in 5-mm increments. Threads were mounted between pins positioned at the anterior, middle, and posterior parts of the tibial and femoral attachments of the sMCL and POL. For different tibial slope modifications, length changes between the tibiofemoral pin combinations were recorded using a rotary encoder as the knee was flexed between 0° and 120°.

resultsAll sMCL fiber regions shortened with slope reduction (

conclusionTibial slope-modifying osteotomies changed the length change pattern of the sMCL such that an AOWHTO increased whereas an ACWHTO decreased the sMCL strain. This effect was most pronounced for the anterior fibers of the sMCL. The length change pattern of the POL remained unaffected by slope-modifying osteotomy. CLINICAL RELEVANCE: Surgeons should be aware that anterior tibial slope-modifying osteotomies affect the biomechanics of the sMCL. After an extensive ACWHTO, patients may develop a medial or anteromedial instability, while an AOWHTO may overconstrain the medial compartment.

Indexed as

CadaverMedial Collateral Ligament, KneeOsteotomyAgedBiomechanical PhenomenaFemaleHumansKnee JointMaleMiddle AgedTibiabiomechanicslength change patternposterior tibial slopeslope modificationsMCLsuperficial medial collateral ligament

Identifiers

PMID39370699
PMCPMC11542327

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.