Structural properties of lateral collateral ligament reconstruction at the fibular head
Structural properties of lateral collateral ligament reconstruction at the fibular head
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DOI：
10.1177/0363546505278704
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发表时间：
2006-01-01
影响因子：
4.8
通讯作者：
Elias, JJ
中科院分区：
文献类型：
--
作者：
Ciccone, WJ;Bratton, DR;Elias, JJ
背景：本文描述了用干涉螺钉固定腓骨头内的同种异体移植组织对断裂外侧副韧带的解剖重建。假设：腓骨头干涉固定不能恢复完整韧带的强度。研究设计：实验室对照研究。方法：对10条完整的外侧副韧带进行失效试验。我们还测试了用带骨塞的移植物重建的11条韧带的远端固定和用不带骨塞的移植物重建的11条韧带的远端固定。结果：腓骨头重建韧带持续失败。完整标本主要因韧带断裂而失效。完整韧带的平均强度和刚度值分别为460 +/- 163 N和82 +/- 25 N/mm，骨塞重建韧带的平均强度和刚度值分别为113 40 N和36 10 N/mm，无骨塞重建韧带的平均强度和刚度值分别为135 81 N和34 14 N/mm。完整韧带的强度和刚度显著高于重建组（P < 0.05）。无骨塞重建的强度变化明显大于骨塞重建的强度变化。结论：腓骨干涉固定重建外侧副韧带时，术后应立即限制张力。由于破坏强度不一致，应谨慎使用软组织固定。临床意义：尽管文献中越来越多地描述腓骨干涉固定，但重建的外侧副韧带的特性以前没有被量化。
Background: Anatomical reconstruction of a ruptured lateral collateral ligament using allograft tissue secured within the fibular head with an interference screw has been described.Hypothesis: Interference fixation at the fibular head does not reproduce the strength of the intact ligament.Study Design: Controlled laboratory study.Methods: Ten intact lateral collateral ligaments were tested to failure. The distal fixation of 11 ligaments reconstructed with a graft including a bone plug and 11 ligaments reconstructed with a graft without a bone plug were also tested.Results: The reconstructed ligaments consistently failed at the fibular head. The intact specimens predominately failed through ligament rupture. The mean strength and stiffness values were 460 +/- 163 N and 82 +/- 25 N/mm, respectively, for the intact ligaments, 113 40 N and 36 10 N/mm, respectively, for reconstruction with a bone plug, and 135 81 N and 34 14 N/mm, respectively, for reconstruction without a bone plug. The strength and stiffness were significantly (P < .05) greater for the intact ligaments than for either reconstruction group. The variation in strength was significantly larger for reconstruction without a bone plug than for reconstruction with a bone plug.Conclusion: Tension applied to lateral collateral ligaments reconstructed using fibular interference fixation should be limited immediately after surgery. Soft tissue fixation should be employed with care because of the inconsistency in the failure strength.Clinical Relevance: Although fibular interference fixation is increasingly being described in the literature, the properties of reconstructed lateral collateral ligaments have not previously been quantified.