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In vivo length change patterns of the medial and lateral collateral ligaments along the flexion path of the knee

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The knowledge of the function of the collateral ligaments—i.e., superficial medial collateral ligament (sMCL), deep medial collateral ligament (dMCL) and lateral collateral ligament (LCL)—in the entire range of knee flexion is important for soft tissue balance during total knee arthroplasty (TKA). The objective of this study was to investigate the length changes of different portions (anterior, middle and posterior) of the sMCL, dMCL and LCL during in vivo weightbearing flexion from full extension to maximal knee flexion.

Methods

Using a dual fluoroscopic imaging system, eight healthy knees were imaged while performing a lunge from full extension to maximal flexion. The length changes of each portion of the collateral ligaments were measured along the flexion path of the knee.

Results

All anterior portions of the collateral ligaments were shown to have increasing length with flexion except that of the sMCL, which showed a reduction in length at high flexion. The middle portions showed minimal change in lengths except that of the sMCL, which showed a consistent reduction in length with flexion. All posterior portions showed reduction in lengths with flexion.

Conclusions

These data indicated that every portion of the ligaments may play important roles in knee stability at different knee flexion range. The soft tissue releasing during TKA may need to consider the function of the ligament portions along the entire flexion path including maximum flexion.

Level of evidence

III.

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Acknowledgments

The authors gratefully acknowledge the support of the National Institutes of Health (R01 AR055612) and the scholarship provided by the Chinese PLA General Hospital.

Conflict of interest

There is no potential conflict of interest to declare.

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Authors and Affiliations

  1. Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA, 02114, USA

    Ali Hosseini, Wei Qi, Tsung-Yuan Tsai, Harry Rubash & Guoan Li

  2. Department of Orthopaedic Surgery, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China

    Wei Qi & Yujie Liu

Authors
  1. Ali Hosseini
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  2. Wei Qi
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  3. Tsung-Yuan Tsai
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  4. Yujie Liu
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  5. Harry Rubash
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  6. Guoan Li
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Correspondence to Guoan Li.

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Hosseini, A., Qi, W., Tsai, TY. et al. In vivo length change patterns of the medial and lateral collateral ligaments along the flexion path of the knee. Knee Surg Sports Traumatol Arthrosc 23, 3055–3061 (2015). https://doi.org/10.1007/s00167-014-3306-9

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  • DOI: https://doi.org/10.1007/s00167-014-3306-9

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