The role of the deep medial collateral ligament in

Authors: Etienne Cavaignac Karel Carpentier Regis Pailhé Thomas Luyckx Johan Bellemans

Publish Date: 2014/06/04

Volume: 23, Issue: 10, Pages: 3101-3107

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Abstract

The tibial insertion of the deep medial collateral ligament dMCL is frequently sacrificed when the proximal tibial cut is performed during total knee arthroplasty The role of the dMCL in controlling the knee’s rotational stability is still controversial The aim of this study was to quantify the rotational laxity induced by an isolated lesion of the dMCL as it occurs during tibial preparation for knee arthroplastyAn isolated resection of the deep MCL was performed in 10 freshfrozen cadaver knees Rotational laxity was measured during application of a standard 50 Nm rotational torque Maximal tibial rotation was measured at different knee flexion angles using an imageguided navigation system Medivision Surgetics system Praxim Grenoble France before and after dMCL resectionIn all cases internal and external tibial rotation increased after dMCL resection Total rotational laxity increased significantly for all knee flexion angles with an average difference of +78° SD 57 with the knee in extension +89° SD 19 in 30° flexion +7° SD 29 in 60° flexion and +53° SD 28 in 90° flexionSacrificing the tibial insertion of the deep MCL increases rotational laxity of the knee by 5°–9° depending on the knee flexion angle Based on our findings new surgical techniques and implants that preserve the dMCL insertion such as tibial inlay components should be developed Further clinical evaluations are necessary

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