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08.09.2016 | Knee | Ausgabe 4/2017

Knee Surgery, Sports Traumatology, Arthroscopy 4/2017

Kinematics of ACL and anterolateral ligament. Part I: Combined lesion

Zeitschrift:
Knee Surgery, Sports Traumatology, Arthroscopy > Ausgabe 4/2017
Autoren:
T. Bonanzinga, C. Signorelli, A. Grassi, N. Lopomo, L. Bragonzoni, S. Zaffagnini, M. Marcacci

Abstract

Purpose

To quantify the influence of ALL lesions on static and dynamic laxity in ACL-deficient knee.

Methods

The study was performed in 10 fresh-frozen knees. The joints were analysed in the following conditions: intact, ACL resection and ACL + ALL resection. Testing parameters were defined as: anterior displacement at 30° and 90° of flexion (AP30, AP90) applying a manual-maximum load; internal rotation at 30° and 90° of flexion (INT30, INT90) applying a 5 N m torque and internal rotation and acceleration during manual pivot-shift (PS) test. Kinematics was acquired by a navigation system; a testing rig and a torquemeter were used to control the limb position and the applied torque. Paired Student’s t test was conducted to assess statistical difference, and significance was set at P < 0.05.

Results

The ALL resection determined a significant increase in terms of internal rotation (INT30 P = 0.02, INT90 P = 0.03), while AP30 (P n.s) and AP90 (P n.s) were not affected. ALL resection produced a significant increase in terms of acceleration during PS test (P < 0.01), but no significant change in PS internal rotation was observed.

Conclusion

The ALL plays a significant role in controlling static internal rotation and acceleration during PS test. On the other hand, ALL resection did not produce any significant change in terms of anterior displacement. A trend was seen for the internal rotation during the pivot-shift test to increase after ALL resection was higher when compared to the intact and isolated ACL lesion states; however, the differences were not significant. The results highlight the clinical relevance of this structure that should be assessed before an ACL reconstruction in order to avoid residual laxity.

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