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Weakening of the knee ligament complex due to sequential medial release in total knee arthroplasty.
- Source :
-
Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2019 Jul; Vol. 139 (7), pp. 999-1006. Date of Electronic Publication: 2019 Apr 08. - Publication Year :
- 2019
-
Abstract
- Purpose: The purpose of this study was to investigate the effects of sequential medial release on the stiffness and collateral stability of the ligament complex of the knee. Irrespective of the implantation technique used, varus deformity frequently requires release of the capsular ligament complex. Yet, no data are available on how stiffness and stability of the knee ligament complex are weakened by such release.<br />Methods: After total knee arthroplasty, ten healthy Thiel-fixed knee joints were subjected to sequential medial release consisting of six release steps. After each step, stiffness and stability were determined at 0°, 30°, 60°, and 90°.<br />Results: Sequential medial release increasingly weakened the ligament complex. In extension, release of the anteromedial tibial sleeve 4 cm below the joint line already weakened the ligament complex by approximately 13%. Release 6 cm below the joint line reduced stiffness and stability by 15-20% over the entire range of motion. After detachment of the medial collateral ligament, stability was only about 60% of its initial value.<br />Conclusion: Our study showed for the first time the association between medial release and stiffness and stability of the knee ligament complex. To maintain stability, vigorous detachment of the knee ligament complex should be avoided. Release of the anteromedial tibial sleeve already initiates loss of stability. The main stabiliser is the medial ligament, which should never be completely detached.<br />Level of Evidence: IV.
- Subjects :
- Cadaver
Humans
Medial Collateral Ligament, Knee surgery
Models, Anatomic
Range of Motion, Articular
Arthroplasty, Replacement, Knee adverse effects
Arthroplasty, Replacement, Knee methods
Knee Joint physiopathology
Knee Joint surgery
Ligaments, Articular physiopathology
Osteoarthritis, Knee surgery
Postoperative Complications diagnosis
Postoperative Complications etiology
Postoperative Complications physiopathology
Postoperative Complications prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1434-3916
- Volume :
- 139
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Archives of orthopaedic and trauma surgery
- Publication Type :
- Academic Journal
- Accession number :
- 30963234
- Full Text :
- https://doi.org/10.1007/s00402-019-03181-z