Tommaso Bonanzinga1,2, Cecilia Signorelli3,4, Nicola Lopomo5,6, Alberto Grassi7,8, Maria Pia Neri9,10, Giuseppe Filardo11,12, Stefano Zaffagnini13,14, Maurilio Marcacci15,16. 1. Clinica Ortopedica e Traumatologica II, Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, via di Barbiano, 1/10, 40136, Bologna, Italy. t.bonanzinga@gmail.com. 2. Dipartimento di Scienze Anatomiche Umane e Fisiopatologia dell'Apparato Locomotore, Università di Bologna, Alma Mater Studiorum, Bologna, Italy. t.bonanzinga@gmail.com. 3. Clinica Ortopedica e Traumatologica II, Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, via di Barbiano, 1/10, 40136, Bologna, Italy. c.signorelli@biomec.ior.it. 4. Dipartimento di Scienze Anatomiche Umane e Fisiopatologia dell'Apparato Locomotore, Università di Bologna, Alma Mater Studiorum, Bologna, Italy. c.signorelli@biomec.ior.it. 5. Clinica Ortopedica e Traumatologica II, Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, via di Barbiano, 1/10, 40136, Bologna, Italy. n.lopomo@biomec.ior.it. 6. Dipartimento di Scienze Anatomiche Umane e Fisiopatologia dell'Apparato Locomotore, Università di Bologna, Alma Mater Studiorum, Bologna, Italy. n.lopomo@biomec.ior.it. 7. Clinica Ortopedica e Traumatologica II, Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, via di Barbiano, 1/10, 40136, Bologna, Italy. alberto.grassi@ior.it. 8. Dipartimento di Scienze Anatomiche Umane e Fisiopatologia dell'Apparato Locomotore, Università di Bologna, Alma Mater Studiorum, Bologna, Italy. alberto.grassi@ior.it. 9. Clinica Ortopedica e Traumatologica II, Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, via di Barbiano, 1/10, 40136, Bologna, Italy. mariapia.neri@ior.it. 10. Dipartimento di Scienze Anatomiche Umane e Fisiopatologia dell'Apparato Locomotore, Università di Bologna, Alma Mater Studiorum, Bologna, Italy. mariapia.neri@ior.it. 11. Clinica Ortopedica e Traumatologica II, Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, via di Barbiano, 1/10, 40136, Bologna, Italy. giuseppe@filardo.eu. 12. Dipartimento di Scienze Anatomiche Umane e Fisiopatologia dell'Apparato Locomotore, Università di Bologna, Alma Mater Studiorum, Bologna, Italy. giuseppe@filardo.eu. 13. Clinica Ortopedica e Traumatologica II, Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, via di Barbiano, 1/10, 40136, Bologna, Italy. stefano.zaffagnini@unibo.it. 14. Dipartimento di Scienze Anatomiche Umane e Fisiopatologia dell'Apparato Locomotore, Università di Bologna, Alma Mater Studiorum, Bologna, Italy. stefano.zaffagnini@unibo.it. 15. Clinica Ortopedica e Traumatologica II, Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, via di Barbiano, 1/10, 40136, Bologna, Italy. m.marcacci@biomec.ior.it. 16. Dipartimento di Scienze Anatomiche Umane e Fisiopatologia dell'Apparato Locomotore, Università di Bologna, Alma Mater Studiorum, Bologna, Italy. m.marcacci@biomec.ior.it.
Abstract
PURPOSE: Posterolateral corner structures functionally interact with the ACL. The aim of this study was to investigate the capability of an isolated ACL reconstruction control laxity parameters in a knee with combined ACL and PLC and the increase in terms of laxity produced by the resection of the PC in an ACL-deficient knee. METHOD: An in vitro cadaveric study was performed on seven knees. The joints were analysed in the following conditions: intact, after ACL resection, after popliteus complex resection, after ACL reconstruction and after LCL. Testing laxity parameters were recorded with an intra-operative navigation system and defined as: AP displacement at 30° and 90° of flexion (AP30 and AP90) applying a 130 N load and IE at 30° and 90° of knee flexion with a 5 N load. RESULTS: Sectioning the ACL significantly increased the AP30 at 30° and 90° of knee flexion (p < 0.05). At 90° of knee flexion, the resection of the LCL determined a significant increase in terms of AP laxity (p < 0.05). At 90° has been found a significant difference for the IE laxity (p < 0.05) after PC resection. Sectioning the LCL produced a significant increase in IE laxity at 30° and 90° of knee flexion (p < 0.05). CONCLUSION: Isolated ACL reconstruction is able to control the AP laxity with a combined complete lesion of the PLC at 30° of knee flexion, but not at higher angle of knee flexion. Considering the IE rotations, the reconstruction was not sufficient not even to control a partial lesion of the PLC. These findings suggest that additional surgical procedures should be considerate even when facing combined PLC lesion.
PURPOSE: Posterolateral corner structures functionally interact with the ACL. The aim of this study was to investigate the capability of an isolated ACL reconstruction control laxity parameters in a knee with combined ACL and PLC and the increase in terms of laxity produced by the resection of the PC in an ACL-deficient knee. METHOD: An in vitro cadaveric study was performed on seven knees. The joints were analysed in the following conditions: intact, after ACL resection, after popliteus complex resection, after ACL reconstruction and after LCL. Testing laxity parameters were recorded with an intra-operative navigation system and defined as: AP displacement at 30° and 90° of flexion (AP30 and AP90) applying a 130 N load and IE at 30° and 90° of knee flexion with a 5 N load. RESULTS: Sectioning the ACL significantly increased the AP30 at 30° and 90° of knee flexion (p < 0.05). At 90° of knee flexion, the resection of the LCL determined a significant increase in terms of AP laxity (p < 0.05). At 90° has been found a significant difference for the IE laxity (p < 0.05) after PC resection. Sectioning the LCL produced a significant increase in IE laxity at 30° and 90° of knee flexion (p < 0.05). CONCLUSION: Isolated ACL reconstruction is able to control the AP laxity with a combined complete lesion of the PLC at 30° of knee flexion, but not at higher angle of knee flexion. Considering the IE rotations, the reconstruction was not sufficient not even to control a partial lesion of the PLC. These findings suggest that additional surgical procedures should be considerate even when facing combined PLC lesion.
Authors: Robert F LaPrade; Steinar Johansen; Fred A Wentorf; Lars Engebretsen; Justin L Esterberg; Andy Tso Journal: Am J Sports Med Date: 2004-07-20 Impact factor: 6.202
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Authors: Matthew D Driscoll; Gene P Isabell; Michael A Conditt; Sabir K Ismaily; Daniel C Jupiter; Philip C Noble; Walter R Lowe Journal: Arthroscopy Date: 2012-07-15 Impact factor: 4.772
Authors: T Bonanzinga; C Signorelli; A Grassi; N Lopomo; L Bragonzoni; S Zaffagnini; M Marcacci Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-09-08 Impact factor: 4.342
Authors: Volker Musahl; Alan Getgood; Philippe Neyret; Steven Claes; Jeremy M Burnham; Cecile Batailler; Bertrand Sonnery-Cottet; Andy Williams; Andrew Amis; Stefano Zaffagnini; Jón Karlsson Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-03-12 Impact factor: 4.342
Authors: Robert W Westermann; Robert G Marx; Kurt P Spindler; Laura J Huston; Annunziato Amendola; Jack T Andrish; Robert H Brophy; Warren R Dunn; David C Flanigan; Morgan H Jones; Christopher C Kaeding; Matthew J Matava; Eric C McCarty; Richard D Parker; Emily K Reinke; Armando F Vidal; Michelle L Wolcott; Brian R Wolf Journal: Orthop J Sports Med Date: 2019-07-30
Authors: S Zaffagnini; F Urrizola; C Signorelli; A Grassi; T Roberti Di Sarsina; G A Lucidi; G M Marcheggiani Muccioli; T Bonanzinga; M Marcacci Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-10-15 Impact factor: 4.342