The American journal of sports medicine
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The effect of simulated ankle ligamentous injury on ankle-subtalar joint complex laxity was studied. Thirty-six intact ankles were loaded in inversion-eversion and anterior-posterior directions. Motions of the talus and calcaneus were measured with respect to the tibia. ⋯ Similarly, laxity in 15 degrees of dorsiflexion and in neutral suggests calcaneofibular ligament disruption. During inversion-eversion loading, the increase in ankle-subtalar joint complex rotation with calcaneofibular ligament sectioning occurred primarily in the ankle joint, implying that the calcaneofibular ligament constrains the talus through the calcaneus. Therefore, a talar tilt on stress radiographs demonstrates a torn calcaneofibular ligament.
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Comparative Study
Biomechanical comparison of reconstruction techniques in simulated lateral ankle ligament injury.
Eighteen intact ankles were loaded with inversion-eversion and anterior-posterior forces, and motions of the talus and calcaneus were measured. Ankles were tested in neutral, 15 degrees of dorsiflexion, and 15 degrees of plantar flexion. The anterior talofibular ligament was then sectioned and testing was repeated. ⋯ For the anterior talofibular and calcaneofibular ligament cut ankles, subtalar joint motion was similar to that in intact ankles after each reconstruction. All three reconstructions resulted in ankles with significantly less subtalar joint motion with anterior-posterior loading than ankles with the anterior talofibular ligament cut or with the anterior talofibular and calcaneofibular ligaments cut. The Chrisman-Snook procedure resulted in ankles with significantly less motion than intact ankles.
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The purpose of this study was to determine the cause of acute hemarthrosis of the knee in a prospective pediatric patient population. Between December 1988 and August 1991, 21 consecutive children who were seen with an acute traumatic hemarthrosis of the knee had an arthroscopic evaluation. The average age of the children at the time of injury was 14 years, 3 months (range, 10 to 17 years). ⋯ We concluded that in children an acute traumatic hemarthrosis reflects a major injury to the knee. The children in this study had a high frequency of osteochondral fractures; ACL injuries were found in only two patients. Because of the unreliable nature of radiographic evaluation, arthroscopic evaluation is a valuable tool in differential diagnosis and treatment of acute hemarthrosis of the knee.
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To study the structural and functional properties of the human posterior cruciate ligament complex, we measured the cross-sectional shape and area of the anterior cruciate, posterior cruciate, and meniscofemoral ligaments in eight cadaveric knees. The posterior cruciate ligament increased in cross-sectional area from tibia to femur, and the anterior cruciate ligament area decreased from tibia to femur. The meniscofemoral ligaments did not change shape in their course from the lateral meniscus to their femoral insertions. ⋯ The posterior cruciate ligament was divided into two functional components: the anterolateral, which is taut in knee flexion, and the posteromedial, which is taut in knee extension. The anterolateral component had a significantly greater linear stiffness and ultimate load than both the posteromedial component and meniscofemoral ligaments. The anterolateral component and the meniscofemoral ligaments displayed similar elastic moduli, which were both significantly greater than that of the posteromedial component.