Biomechanical Assessment of Knee Laxity After a Novel Posterolateral Corner Reconstruction Technique.

Background: Different techniques to restore knee stability after posterolateral corner (PLC) injury have been described. The original anatomic PLC reconstruction uses 2 separate allografts to reconstruct the PLC. Access to allograft tissue continues to be a significant limitation of this technique, which led to the development of a modified anatomic approach utilizing a single autologous semitendinosus graft fixed on the tibia with an adjustable suspensory loop to enable differential tensioning of the PLC components.

No Difference in Ligamentous Strain or Knee Kinematics Between Rectangular or Cylindrical Femoral Tunnels During Anatomic ACL Reconstruction With a Bone-Patellar Tendon-Bone Graft.

Background: As our understanding of anterior cruciate ligament (ACL) anatomy has evolved, surgical techniques to better replicate the native anatomy have been developed. It has been proposed that the introduction of a rectangular socket ACL reconstruction to replace a ribbon-shaped ACL has the potential to improve knee kinematics after ACL reconstruction.

Purpose: To compare a rectangular femoral tunnel (RFT) with a cylindrical femoral tunnel (CFT) in terms of replicating native ACL strain and knee kinematics in a time-zero biomechanical anatomic ACL reconstruction model using a bone-patellar tendon-bone (BTB) graft.

Accuracy and precision of image-based strain measurement using embedded radiopaque markers.

The purpose of this work was to assess the resolution to which micro-CT and intra-operative CT systems can quantify distances between radiopaque fiducial markers. Twenty-two markers were cast in a silicone phantom, then imaged at ten random rotations and translations within the field of view of a micro-CT and an intraoperative CT. A bounding box method and a mask-based weighted binary method were used to calculate the location of all markers in an image, then the Euclidian distance between neighbouring marker coordinates was calculated.

Lateral Compartment Contact Pressures Do Not Increase After Lateral Extra-articular Tenodesis and Subsequent Subtotal Meniscectomy.

Background: Modified Lemaire lateral extra-articular tenodesis (LET) has been proposed as a method of addressing persistent anterolateral rotatory laxity after anterior cruciate ligament (ACL) reconstruction (ACLR). However, concerns remain regarding the potential for increasing lateral compartment contact pressures.

Purpose: To investigate changes in tibiofemoral joint contact pressures after isolated ACLR and combined ACLR plus LET with varying states of a lateral meniscal injury.

Development and Assessment of a Microcomputed Tomography Compatible Five Degrees-of-Freedom Knee Joint Motion Simulator.

Currently available knee joint kinematic tracking systems fail to nondestructively capture the subtle variation in joint and soft tissue kinematics that occur in native, injured, and reconstructed joint states. Microcomputed tomography (CT) imaging has the potential as a noninvasive, high-resolution kinematic tracking system, but no dynamic simulators exist to take advantage of this. The purpose of this work was to develop and assess a novel micro-CT compatible knee joint simulator to quantify the knee joint's kinematic and kinetic response to clinically (e.

Anterolateral Knee Extra-articular Stabilizers: A Robotic Sectioning Study of the Anterolateral Ligament and Distal Iliotibial Band Kaplan Fibers.

Background: The individual kinematic roles of the anterolateral ligament (ALL) and the distal iliotibial band Kaplan fibers in the setting of anterior cruciate ligament (ACL) deficiency require further clarification. This will improve understanding of their potential contribution to residual anterolateral rotational laxity after ACL reconstruction and may influence selection of an anterolateral extra-articular reconstruction technique, which is currently a matter of debate. Hypothesis/Purpose: To compare the role of the ALL and the Kaplan fibers in stabilizing the knee against tibial internal rotation, anterior tibial translation, and the pivot shift in ACL-deficient knees.

Anterolateral Knee Extra-articular Stabilizers: A Robotic Study Comparing Anterolateral Ligament Reconstruction and Modified Lemaire Lateral Extra-articular Tenodesis.

Background: Persistent clinical instability after anterior cruciate ligament (ACL) reconstruction may be associated with injury to the anterolateral structures and has led to renewed interest in anterolateral extra-articular procedures. The influence of these procedures on knee kinematics is controversial. Purpose/Hypothesis: The purpose was to investigate the biomechanical properties of anatomic anterolateral ligament (ALL) reconstruction and a modified Lemaire procedure (lateral extra-articular tenodesis [LET]) in combination with ACL reconstruction as compared with isolated ACL reconstruction in the setting of deficient anterolateral structures (ALL and Kaplan fibers).

Lateral Extra-articular Tenodesis Reduces Rotational Laxity When Combined With Anterior Cruciate Ligament Reconstruction: A Systematic Review of the Literature.

Purpose: To determine whether the addition of lateral extra-articular tenodesis (LET) to anterior cruciate ligament (ACL) reconstruction would provide greater control of rotational laxity and improved clinical outcomes compared with ACL reconstruction alone.

Methods: Two independent reviewers searched 9 databases for randomized and nonrandomized clinical studies comparing ACL reconstruction plus LET versus ACL reconstruction alone in a human adult population. All years and 5 languages were included.

Biomechanical analysis of simulated clinical testing and reconstruction of the anterolateral ligament of the knee.

Background: Anatomic anterolateral ligament (ALL) reconstruction has been proposed to assist anterior cruciate ligament (ACL) reconstruction in controlling anterolateral rotational laxity of the knee. However, the biomechanical effects have not been reported.

Purpose: (1) To investigate the effect of ALL transection on rotational knee kinematics and (2) to determine the effect on knee biomechanics of ALL reconstruction procedures compared with lateral extra-articular tenodesis (LET).

Radiographic landmarks for surgical reconstruction of the anterolateral ligament of the knee.

Purpose: To determine the radiographic landmarks of the anterolateral ligament (ALL) on the femur and tibia to assist in intraoperative graft placement during ALL reconstruction.

Methods: The footprints of the ALL, fibular collateral ligament (FCL), popliteus insertion, lateral gastrocnemius insertion, and Gerdy's tubercle were isolated and centrally marked with tantalum beads in thirteen fresh-frozen cadaveric knees. Measurements were taken from the true lateral fluoroscopic images.

Effect of a solution of hyaluronic acid-chondroitin sulfate-N-acetyl glucosamine on the repair response of cartilage to single-impact load damage.

Objective: To investigate effects of 1% hyaluronic acid-chondroitin sulfate-N-acetyl glucosamine (HCNAG) on the damage repair response in equine articular cartilage.

Sample: Articular cartilage from 9 clinically normal adult horses.

Procedures: Full-thickness cartilage disks were harvested from the third metacarpal bone.

Evaluation of early-stage osteochondral defect repair using a biphasic scaffold based on a collagen-glycosaminoglycan biopolymer in a caprine model.

The aim of this study was to evaluate a new collagen-GAG-calcium phosphate biphasic scaffold for the repair of surgically created osteochondral defects in goats. Comparison of morphological, histological and mechanical performance of the repair tissue was made with defects repaired using a synthetic polymer scaffold. Defects were created in the medial femoral condyle (MFC) and lateral trochlear sulcus (LTS) of Boer Cross goats and evaluated at 12 and 26 weeks.