Document Title: LaPrade-AJSM-Jul99

Article Title: The effects of grade III posterolateral knee complex injuries on anterior cruciate ligament graft force: A biomechanical analysis

Authors: Robert F. LaPrade, Scott Resig, Fred Wentorf, Jack L. Lewis.

Publication: The American Journal of Sports Medicine

ISSN: 03635465

Date: July-August 1999.

(Figures included. Reference-denoting numbers appear in the same point size as document text.  Note that in this document, "posterolateral complex" refers to the LCL in association with several other components, but not the PCL.)

 

Volume: 27

Issue: 4

Pages: 469-475

Key Words: Knee, ligaments, posterolateral, PCL, biomechanics

 

This study shows that untreated grade III posterolateral-structure injuries contribute to anterior-cruciate-ligament graft failure by exposing the nascent ligament to higher forcing. (Note that the term "posterolateral structures" refers the LCL along with several other structures [popliteus tendon, arcuate ligament complex, and lateral capsular ligament], but not the PCL.)

 

This document was presented at the 24th annual meeting of the AOSSM, Vancouver, British Columbia, Canada, June 1998.

 

ABSTRACT

 

To determine if untreated grade III injuries of the posterolateral structures contribute to increased force on an anterior cruciate ligament graft, we measured the force in the graft in cadaveric knees during joint loading after reconstruction with otherwise intact structures and in the same reconstructed knees after selected cutting of specific posterolateral knee structures. Tests were first performed on the knee with the posterolateral structures intact and then after sequential sectioning of the fibular collateral ligament, popliteofibular ligament, and popliteus tendon. The graft force was significantly higher after fibular collateral ligament transection during varus loading at both 0 deg and 30 deg of knee flexion than it was for the same loading of the joint with intact posterolateral structures. In addition, coupled loading of varus and internal rotation moments at 0 degrees and 30 degrees of flexion further increased graft force beyond that with varus force alone. The increase in graft force remained significant with additional sequential cutting of the popliteofibular ligament and popliteus tendon. We believe this study supports the clinical observation that untreated grade III posterolateral structure injuries contribute to anterior cruciate ligament graft failure by allowing higher forces to stress the graft.

 

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