Understanding the contribution of the soft-tissues to total joint constraint (TJC) is important for predicting joint kinematics, developing surgical procedures, and increasing accuracy of computational models. Previous studies on the collateral ligaments have focused on quantifying strain and tension properties under discrete loads or kinematic paths; however, there has been little work to quantify collateral ligament contribution over a broad range of applied loads and range of motion (ROM) in passive constraint. To accomplish this, passive envelopes were collected from nine cadaveric knees instrumented with implantable pressure transducers (IPT) in the collateral ligaments. The contributions from medial and lateral collateral ligaments (LCL) were quantified by the relative contribution of each structure at various flexion angles (0-120 deg) and compound external loads (±10 N m valgus, ±8 N m external, and ±40 N anterior). Average medial collateral ligament (MCL) contributions were highest under external and valgus torques from 60 deg to 120 deg flexion. The MCL showed significant contributions to TJC under external torques throughout the flexion range. Average LCL contributions were highest from 0 deg to 60 deg flexion under external and varus torques, as well as internal torques from 60 deg to 110 deg flexion. Similarly, these regions were found to have statistically significant LCL contributions. Anterior and posterior loads generally reduced collateral contribution to TJC; however, posterior loads further reduced MCL contribution, while anterior loads further reduced LCL contribution. These results provide insight to the functional role of the collaterals over a broad range of passive constraint. Developing a map of collateral ligament contribution to TJC may be used to identify the effects of injury or surgical intervention on soft-tissue, and how collateral ligament contributions to constraint correlate with activities of daily living.
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http://dx.doi.org/10.1115/1.4029980 | DOI Listing |
Zhongguo Zhen Jiu
January 2025
Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Ningxia Ethomedicine Modernization, Ministry of Education, Yinchuan 750004.
Objective: To observe the clinical effect of internal heat acupuncture therapy for knee osteoarthritis of early to middle stages, and explore its influence on cartilage thickness.
Methods: A total of 44 patients with knee osteoarthritis of early to middle stages were treated with internal heat acupuncture therapy at points (most of them are located at the subpatellar fat pad, both sides of the patellar ligament, the tendon of the quadriceps and the attachment of the medial and lateral collateral ligaments), once a week, a total of 4 weeks of treatment. Before and after treatment, after 3 months of treatment completion (in the follow-up), the visual analogue scale (VAS) score, Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score, frequency of 30-second chair stand test (30sCST), cartilage thickness of femoral intercondylar and knee joint ultrasound score were compared, and the clinical effect was evaluated.
Medicina (Kaunas)
December 2024
Department of Orthopedic Surgery, Chungnam National University Hospital, School of Medicine, Chungnam National University, Munhwa-ro 282, Jung-gu, Daejeon 35015, Republic of Korea.
: This study investigated associated meniscus and ligament injuries in tibial plateau fractures using magnetic resonance imaging (MRI) and assessed soft tissue injuries in relation to the Schatzker classification and Tscherne classification. : The data of 185 patients who sustained tibial plateau fractures from January 2010 to April 2021 were retrospectively reviewed. Fractures were classified according to the Schatzker classification system.
View Article and Find Full Text PDFBiomedicines
November 2024
Clinic for Trauma and Reconstructive Surgery, University Hospital Heidelberg, 69118 Heidelberg, Germany.
: The elbow joint is stabilized by complex interactions between bony structures and soft tissues, notably the lateral and medial collateral ligaments. Posterolateral rotatory instability (PLRI), a form of elbow instability, is challenging to diagnose due to overlapping symptoms with other conditions. The radiocapitellar line (RCL) is a radiographic tool for assessing humeroradial alignment and elbow stability, but its diagnostic accuracy remains debated.
View Article and Find Full Text PDFJ Exp Orthop
January 2025
Department of Orthopaedic and Trauma Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim University of Heidelberg Mannheim Germany.
Purpose: This biomechanical study aimed to investigate the effectiveness of a hinged elbow orthosis in reducing passive valgus forces following medial ulnar collateral ligament (UCL) injuries of the elbow joint. The hypothesis tested was that a hinged elbow orthosis reduces these passive valgus forces.
Methods: Eight fresh frozen cadaveric elbow specimens were prepared and tested under three scenarios: intact ligaments, simulated UCL rupture and application of a hinged elbow brace after simulated UCL rupture.
The incidence of ulnar collateral ligament injuries has increased over the past decade. As a result, the rate of ulnar collateral ligament reconstruction has increased dramatically at all levels of competition in overhead athletes. Currently, there is no consensus on milestones during rehabilitation or a largely agreed-upon structured throwing program after ulnar collateral ligament injuries.
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