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Beitragstitel Elongation patterns of posterolateral corner reconstruction techniques in a three-dimensional weight-bearing computed tomography simulation
Beitragscode P38
Autoren
  1. Sandro Hodel Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland Vortragender
  2. Julian Hasler
  3. Philipp Fürnstahl Universitätsklinik Balgrist, Zürich
  4. Sandro F. Fucentese Balgrist Universitätsklinik
  5. Lazaros Vlachopoulos Balgrist Universitätsklinik
Präsentationsform Poster
Themengebiete
  • A05 - Knie
Abstract Background
Various surgical techniques to reconstruct the posterolateral corner (PLC) of the knee have been developed, including non-anatomical and anatomical techniques. The isometric characteristics of non-anatomical and anatomical PLC reconstruction techniques under weight-bearing conditions remain unclear.
Purpose
The primary aim of this study was to simulate graft elongation patterns during knee flexion for three different PLC reconstruction techniques (Larson, Arciero, LaPrade). The secondary aim was to compute the most isometric insertion points of the fibular collateral ligament (FCL) graft strands for each technique and to report quantitative radiographic landmarks.
Methods
A three-dimensional simulation of weight-bearing CT scans of ten healthy knees from 0-120 ° of knee flexion was performed. Ligament length changes during knee flexion for the PLC reconstruction techniques of Larson, Arciero, and LaPrade were analyzed. The most isometric femoral insertion points for the FCL graft strands were computed within a 10 mm radius around the lateral epicondyle (LE), using an automatic string generation algorithm (isometric score 0 indicating perfect isometry). Radiographic landmarks for the most isometric points were reported.
Results
Median graft lengthening during knee flexion was similar for the anterior graft stands of Larson’s technique 3.6 mm (range 1.7 to 7.2 mm) compared to Arciero’s and LaPrade’s techniques 2.2 mm (range 0.0 to 5.6 mm) (ns). The posterior graft strands demonstrated shortening of 17.1 mm (- 9.3 to - 22.3) for Larson’s technique compared to significant lengthening for Arciero’s and LaPrade’s technique of 9.9 mm (range 6.7 to 15.9 mm) and 10.2 mm (range 4.1 to 19.7 mm) respectively (p < 0.001). The most isometric point could be defined for the FCL graft strands of all techniques and was located at a median of 2.2 mm (range - 2.2 to 4.6 mm) posterior and 0.5 mm (range - 1.8 to 3.7 mm) distal to the LE.
Conclusion
Significant lengthening of the posterior graft strands of Arciero’s and LaPrade’s PLC reconstruction techniques occurred compared to shortening of the posterior graft strand of Larson’s technique during knee flexion. The most isometric point could be defined for the FCL graft strands of each PLC reconstruction technique and is located postero-distal to the LE.