Hideya Ishigooka1, Sean T Campbell2, Ryan J Quigley3, Michelle H McGarry3, Yu Jen Chen3, Akash Gupta3, Christopher N H Bui3, Thay Q Lee4. 1. Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System and University of California, Irvine, California, U.S.A.; Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan. 2. Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System and University of California, Irvine, California, U.S.A.; Department of Orthopaedic Surgery, Stanford University, Redwood City, California, U.S.A. 3. Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System and University of California, Irvine, California, U.S.A. 4. Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System and University of California, Irvine, California, U.S.A.. Electronic address: tqlee@med.va.gov.
Abstract
PURPOSE: To compare the biomechanical properties of a fibula cross-tunnel technique for posterolateral corner (PLC) reconstruction with those of intact knees. METHODS: Seven fresh-frozen cadaveric knees were tested while intact, after PLC tear, and after reconstruction. Testing of the parameters listed above was performed at 0°, 30°, 60°, and 90° of knee flexion. Reconstruction was performed using 2 independent tendon autografts. Afterward, the fibula and graft were loaded to failure. RESULTS: Reconstruction restored external rotation (0°: 11.75° ± 2.02° to 9.81° ± 1.81°, P = .57; 30°: 17.91° ± 1.32° to 13.96° ± 2.84°, P = .12; 60°: 15.86° ± 1.68° to 13.26° ± 3.58°, P = .41; 90°: 15.53° ± 1.62° to 14.07° ± 2.95°, P = .54) to the intact state, and posterior translation (0°: 3.66 ± 0.85 mm to 3.31 ± 0.89 mm, P = .87; 60°: 3.15 ± 0.45 mm to 2.96 ± 0.45 mm, P = .73; 90°: 2.74 ± 0.33 mm to 3.05 ± 0.41 mm, P = .41) and varus angulation (0°: 0.92° ± 0.35° to 1.98° ± 0.42°, P = .55; 30°: 2.65° ± 0.27° to 1.09° ± 0.90°, P = .37; 90°: 4.29° ± 0.44° to 2.53° ± 1.13°, P = .19) under most conditions. During load to failure testing, the construct revealed properties similar to those of native structures (yield load: 330.4 ± 45.8 N; ultimate load: 420.9 ± 37.4 N). CONCLUSIONS: This technique restored external rotation to the intact state after PLC injury in all testing conditions, as well as posterior translation at 0°, 60°, and 90° of flexion, and varus angulation under all conditions tested except 60° of flexion. CLINICAL RELEVANCE: Clinically, this surgical technique may eliminate the need for a tibial tunnel for posterolateral corner reconstruction.
PURPOSE: To compare the biomechanical properties of a fibula cross-tunnel technique for posterolateral corner (PLC) reconstruction with those of intact knees. METHODS: Seven fresh-frozen cadaveric knees were tested while intact, after PLC tear, and after reconstruction. Testing of the parameters listed above was performed at 0°, 30°, 60°, and 90° of knee flexion. Reconstruction was performed using 2 independent tendon autografts. Afterward, the fibula and graft were loaded to failure. RESULTS: Reconstruction restored external rotation (0°: 11.75° ± 2.02° to 9.81° ± 1.81°, P = .57; 30°: 17.91° ± 1.32° to 13.96° ± 2.84°, P = .12; 60°: 15.86° ± 1.68° to 13.26° ± 3.58°, P = .41; 90°: 15.53° ± 1.62° to 14.07° ± 2.95°, P = .54) to the intact state, and posterior translation (0°: 3.66 ± 0.85 mm to 3.31 ± 0.89 mm, P = .87; 60°: 3.15 ± 0.45 mm to 2.96 ± 0.45 mm, P = .73; 90°: 2.74 ± 0.33 mm to 3.05 ± 0.41 mm, P = .41) and varus angulation (0°: 0.92° ± 0.35° to 1.98° ± 0.42°, P = .55; 30°: 2.65° ± 0.27° to 1.09° ± 0.90°, P = .37; 90°: 4.29° ± 0.44° to 2.53° ± 1.13°, P = .19) under most conditions. During load to failure testing, the construct revealed properties similar to those of native structures (yield load: 330.4 ± 45.8 N; ultimate load: 420.9 ± 37.4 N). CONCLUSIONS: This technique restored external rotation to the intact state after PLC injury in all testing conditions, as well as posterior translation at 0°, 60°, and 90° of flexion, and varus angulation under all conditions tested except 60° of flexion. CLINICAL RELEVANCE: Clinically, this surgical technique may eliminate the need for a tibial tunnel for posterolateral corner reconstruction.