MCL internal brace does not fully recapitulate normal MCL function in valgus stress Journal Article uri icon
Overview
abstract
  • PURPOSE: The null hypothesis is that there would be no difference in medial gapping under valgus load between the intact MCL and the ruptured MCL with an internal brace in place. METHODS: Eight pairs of cadaver knees were used (16 knees). Alternating sides, one knee from each pair was used for one of two "internal brace" constructs. The constructs involved different methods of fixation for securing FiberTape (Arthrex, Naples, FL) to both the femur and tibia in an effort to brace the MCL. The knees were then subjected to valgus stress by applying 10聽N聽m of torque with the knee at 20 degrees of flexion. The amount of medial joint space opening was measured on radiographs. The stress testing was conducted with three MCL states: intact, grade 2 tear, and grade 3 tear. RESULTS: In the Construct I specimens, gapping increased from 0.7聽mm with the MCL intact to 1.1聽mm with grade 2 tearing (p鈥�<鈥�0.01), and to 1.3聽mm with grade 3 tearing (p鈥�<鈥�0.01). In the Construct II specimens, gapping increased from 0.7聽mm with the MCL intact to 1.0聽mm with grade 2 tearing (p鈥�<鈥�0.01), and to 1.1聽mm with grade 3 tearing (n.s.). Construct I specimens failed primarily at the femoral attachment. All Construct II specimens survived the valgus stress testing. CONCLUSION: Construct I did not maintain tension. Construct II did maintain tension during application of valgus load, but did not restore valgus opening to the intact state. It is important for clinicians who are considering using this commercially available technique to be aware of how the construct performs under valgus stress testing compared to the intact MCL.

  • Link to Article
  • publication date
  • 2023
  • Research
    keywords
  • Knee
  • Orthopedics
  • Surgery
  • Additional Document Info
    volume
  • 31
  • issue
  • 9