Tibial collateral ligament strain due to occult derangements of the medial meniscus; confirmed by operation in thirty cases.
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Disease↗
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Tibial collateral ligament strain due to occult derangements of the medial meniscus; confirmed by operation in thirty cases.
Explore the source record for details and available documents.
Disease↗
A new device and method for controlling the load in rabbit medial collateral ligament reconstructions.
In order to study the effect of intra-operative tensioning on the laxity and strength of healing ligament grafts in an animal model, a method of quantifying graft tension was needed. In this study a sensitive ligament tensioning device was developed to measure accurately the prefixation loads in the rabbit medial collateral ligament (MCL) graft. To verify that reproducible changes in ligament tension could be created with the tensioning device, a group of animals had their MCL grafts replaced at one of three different graft loads (tight, anatomic, or loose). The tensioning device consists of two posts which move relative to one another by means of an axial screw. The movable post, which is inserted into the tibial bone island of the MCL graft has a series of strain gauges which can measure the tension applied to the graft. The stationary post attaches to the tibial shaft, permitting the ligament graft to be tensioned relative to this fixed point. After graft tensioning and fixation, the animals were euthanized immediately postoperatively and their ligament load-deformation behavior was measured using an Instron materials testing machine. Specific measures of low load behavior was taken to quantify ligament laxity. Our results demonstrate that the tensioning device was capable of reproducibly altering prefixation graft load intra-operatively as well as MCL laxity immediately postoperatively. A baseline of laxity values was thus developed to follow changes in this laxity measure for future studies of MCL graft healing in this model.
Animals↗
MR imaging in chronic rupture of the ulnar collateral ligament of the thumb.
PURPOSE: MR imaging has been shown as the best radiologic method for verifying and classifying acute ulnar collateral ligament (UCL) ruptures of the thumb. Our aim was to analyse the usefulness of MR also in old ruptures and to establish the most useful sequences. MATERIAL AND METHODS: Ten patients with an old UCL rupture of the thumb were preoperatively imaged using 1.5 T MR. Three radiologists blinded to the findings separately analysed the MR images of these patients and of 10 age-and sex-matched voluntary controls. MR findings of the patients were compared with those of surgery. RESULTS: The consensus diagnosis of an UCL rupture was accurate in all 10 patients. All controls were classified as having no UCL rupture. In 5 of the 7 patients with a surgically defined Stener or non-Stener lesion, the consensus diagnosis was the same as the operative diagnosis. Due to excessive scarring it was not possible to verify any Stener lesion intra-operatively in 3 patients. The most informative MR sequence was T2 TSE in the coronal plane, the second most informative was T1 SE with fat suppression in the coronal plane. CONCLUSION: An old UCL rupture is well verified by MR but typing of the lesion as either a Stener or non-Stener type is not always possible.
Adult↗
Investigation of the collagen fibril distribution in the medial collateral ligament in a rat knee model.
This study compared the collagen fibril diameter distribution among six anatomical sites of the rat medial collateral ligament (MCL). Ultrathin MCL sections from 4 male Sprague-Dawley rats were examined electron microscopically. With an automated quantitation method, 41,638 fibrils were measured and compared among the periphery and core regions of the femoral, middle, and tibial portions of the MCL. Results demonstrated significant difference (p < .0033) in mean fibril diameter distribution among the six sites. The mass-averaged diameters of the core and peripheral fibrils were between 175.53 to 190.82 nm and 88.47 to 109.18 nm, respectively, with the peripheral fibrils more homogeneous in size. The fibrils occupied 36.7% to 57.1% of the cross-sectional area of the ligament. About 50% of the fibrils had an oblique factor of 0.8-1.0, implying that most fibrils were aligned longitudinally. This study has provided a detailed profile of the collagen fibril distributions in rat MCL.
Animals↗
Sprain of the short radial collateral ligament in a racing greyhound.
Severe carpal lameness in a racing greyhound due to a sprain of the straight part of the short radial collateral ligament is described. The dog subsequently developed an enthesiopathy at the origin of the ligament. Treatment was by kennel rest and the dog returned to successful racing.
Animals↗
[Rupture of the radial collateral ligament of the fifth metacarpopharyngeal joint. A case report with Stener effect].
We report a case of complete rupture of the radial collateral ligament of the fifth metacarpophalangeal joint. At surgical exploration, a Stener like lesion was identified in which the ruptured and of the ligament was trapped by the proximal portion of the extensor hood and sagittal band; thus reattachment to its original site (the base of proximal phalanx) was performed. Postoperative care consisted of protected active motion exercises which were begun immediately. An early functional recovery was obtained with full range of motion, normal joint stability and complete pain relief. The purpose of this study was to present an uncommon injury and to analyse the literature.
Adult↗
Semimembranosus-tibial collateral ligament bursitis: MR imaging findings.
PURPOSE: The purpose of this paper is to describe the MR imaging characteristics of semimembranosus-tibial collateral ligament (SMTCL) bursitis. MATERIALS AND METHODS: Fifteen patients (37-68 years old) with medial joint pain and presumed internal derangements of the knee underwent MR imaging. Fluid collections around the SMTCL were found prospectively in five patients. Our retrospective evaluation of recent MR imaging cases that had been previously diagnosed as pes anserinus bursitis revealed 10 additional cases with similar findings. RESULTS: We believe that SMTCL bursitis clinically explained the patients' medial pain in all cases diagnosed prospectively. We gave the additional cases the same diagnosis presumptively. CONCLUSIONS: SMTCL bursitis has a characteristic MR imaging appearance of fluid draped over the semimembranosus tendon in the shape of an inverted U. This entity can clinically mimic internal derangement of the knee, typically causing pain more superior and posterior to that of pes anserinus bursitis. MR imaging is useful in diagnosing SMTCL bursitis and avoiding unnecessary knee arthroscopy.
Adult↗
The spectrum of ulnar collateral ligament injuries as viewed on magnetic resonance imaging of the metacarpophalangeal joint of the thumb.
OBJECTIVE: To elucidate the spectrum of ulnar collateral ligament (UCL) injuries detectable by magnetic resonance imaging (MRI). METHODS: Twenty-one patients (12 male and 9 female, aged 14-62 years) with acute hyperabduction injuries of the first metacarpophalangeal joint underwent MRI for clinically suspected UCL injuries. All scans were performed in either a large-bore, 1.5-T imager or an experimental small-bore, 1.9-T imager. MRI findings and clinical evaluations of all patients and surgical reports of those who underwent surgery (n = 10) were reviewed and correlated retrospectively. RESULTS: A total of 6 patients demonstrated injuries that did not fall into previously described categories of UCL injuries and therefore illustrated the existence of a subclass of UCL injuries. We divided the MRI findings into 5 categories: Stener's lesions (n = 6), moderately displaced (> or = 3 mm) complete tears (n = 5), minimally displaced (< 3 mm) complete tears (n = 4), nondisplaced complete tears (n = 3) and partial tears (n = 3). None of the MRI scans demonstrated a normal UCL. Although sensitivity and specificity were not calculated, only 2 cases demonstrated discordance between the MRI results and surgical findings or clinical outcomes. CONCLUSION: There is a spectrum of UCL injuries that have not previously been described.
Adolescent↗
Effects of a therapeutic laser on the ultrastructural morphology of repairing medial collateral ligament in a rat model.
BACKGROUND AND OBJECTIVES: Low energy laser therapy has been shown to enhance mechanical strength of healing medial collateral ligament (MCL) in rats. The present study investigated its effects on the ultrastructural morphology and collagen fibril profile of healing MCL in rats. STUDY DESIGN/MATERIALS AND METHODS: Thirty-two mature male Sprague-Dawley (SD) rats were used. Twenty-four underwent surgical transection to their right MCLs and eight received only skin wound. Immediately after surgery, eight of the MCL transected rats were treated with a single dose of laser therapy at 63.2 J cm(-2), eight were treated with a single dose of laser therapy at 31.6 J cm(-2), the rest had no treatment and served as control. At 3 and 6 weeks after surgery, the MCLs were harvested and examined with electron microscopy for collagen fibril size, distribution, and alignment. RESULTS: Significant differences (P < 0.001) were found in fibril diameters from the same anatomical site and time period among different groups. The mass-averaged diameters of the laser-treated (64.99-186.29 nm) and sham (64.74-204.34 nm) groups were larger than the control group (58.66-85.89 nm). The collagen fibrils occupied 42.55-59.78, 42.63-53.94, and 36.92-71.64% of the total cross-sectional areas in the laser-treated, control and sham groups, respectively. Mode obliquity was 0.53-0.84 among the three groups. CONCLUSIONS: Single application of low energy laser therapy increases the collagen fibril size of healing MCLs in rats.
Animals↗
Post traumatic osteoma of tibial insertion of medial collateral ligament of knee joint.
Two cases are presented of post traumatic para-articular osteoma developing at the site of tibial attachment of the medial collateral ligament of knee joint. These occurred after injuries sustained while playing football and in one case the ossified mass was treated with surgical excision for unresolved symptoms after conservative measures. A comparison is made with Pellegrini Stieda disease, which is a similar affection of the femoral insertion of the medial ligament of the knee joint.
Adolescent↗
Ulnar collateral ligament tear with concomitant extensor pollicis brevis and extensor pollicis longus disruptions: a case report.
A patient with a tear of the thumb ulnar collateral ligament and simultaneous extensor pollicis brevis and extensor pollicis longus disruptions is reported. No report of a similar constellation of injuries was found in the literature.
Aged↗
[Lengemann suture versus bone screw osteosynthesis in treatment of ulnar osseous collateral ligament rupture of the thumb metacarpophalangeal joint].
Out of 95 ligamentous lesions of the thumb metacarpophalangeal joint, those with an isolated bony rupture of the ulnar collateral ligament were chosen. Of these, 15 patients treated with Lengemann suture and 16 with screw fixation were followed-up on average 27.3 and 26.4 months, respectively, after operative treatment. Under only "good" and "very good" clinical results, the statistical analysis of the objective and subjective parameters showed no significant difference, except for the measurement of the soft-tissue circumference (p < 0.01) between either procedure. Although both procedures have a low rate of complications, screw fixation is preferable since implant removal is not necessary.
Adult↗
Stiffness of the healing medial collateral ligament of the mouse.
The knee joints of mice can serve as a model for studying knee ligament properties. The goal of our study was to measure the structural stiffness of the medial collateral ligament (MCL) of the murine knee. A tensile test was developed for this purpose. First 84 femur-MCL-tibia complexes of 11-week-old C57Black6 mice were tested. Of four groups (n = 14 per group) the right MCL was ruptured. The mice were sacrificed at 1.5, 3, 6, and 9 weeks after the operation. The other two groups served as controls at 0 and 9 weeks after the operation. Absolute values of the structural stiffness of the healed MCLs at 1.5 weeks were initially significantly lower than their unoperated controls, but were not different from normal values at three, six, and nine weeks of healing. The structural stiffness of the unoperated controls increased by 11% at 20 weeks compared to 11 weeks of age.
Animals↗
Age-related properties of medial collateral ligament and anterior cruciate ligament: a morphologic and collagen maturation study in the rabbit.
The medial collateral ligament (MCL) and anterior cruciate ligament (ACL) from New Zealand white rabbits ages 2, 12, and 36 mos were resected and utilized for analysis by light microscopy and electron microscopy, as well as for determinations of water content, collagen concentration, collagen crosslink (i.e., reducible, nonreducible) analysis, and collagen synthesis rates in vitro. Both modes of microscopy revealed substantial differences between the various age groups. Water content, as well as collagen concentration, decreased significantly from the 2-mo to the 12- or 36- mo groups. The concentration of the reducible crosslinks, associated with less mature tissue, was significantly greater in the younger tissues relative to the aged tissues. The nonreducible crosslink increased with maturation of the collagen in the 36-mo rabbits. Collagen synthesis rates fell from a highest value in the 2-mo group to the lowest in the 36-mo group.
Aging↗
Nonoperative management of complete tears of the medial collateral ligament.
Ten years of experience in treating complete tears of the medial collateral ligament (MCL) nonoperatively are reported, with an emphasis on the role of arthroscopy in the diagnosis of patients with suspected complete MCL tears. Physical examination and assessment of findings are followed by a three-phase treatment protocol. The first phase consists of an orthosis and 30 degrees of flexion, partial weight-bearing with crutches, and strengthening exercises; the second phase allows knee motion from 30 degrees to 90 degrees, followed by the addition of isotonic and isokinetic exercises, and full weight-bearing without crutches, if tolerable; the third phase includes removal of the orthosis, continuation of the exercise regimen, and institution of a running program. Successful treatment depends on clinical or arthroscopic confirmation of a normal anterior cruciate ligament.
Arthroscopy↗
Effects of herbal application on the ultrastructural morphology of repairing medial collateral ligament in a rat model.
The present study investigated the effects of an external herbal application on the ultrastructural morphology of repairing medial collateral ligament (MCL) in a rat model. Eight MCL-transected/herb-treated rats (group 1) were compared with 8 MCL-transected/placebo-treated controls (group 2) and 8 MCL-intact/placebo-treated rats (group 3). At 3 and 6 weeks posttransection, MCL specimens were examined under electron microscope. With analysis of 370,709 collagen fibrils, all herb-treated animals had significantly larger fibrils than the controls (p < .001) at 6 weeks postinjury. The mean diameter of those peripheral collagen fibrils of group 1 was larger than the sham group (p < .001). The mass-averaged diameters of group 1 (50.49 to 143.07 nm) and group 3 (59.69 to 188.88 nm) were larger than group 2 (50.59 to 121.94 nm). The area coverage by collagen fibrils ranged from 46.86 to 94.97% for group 1 and 43.70 to 68.08%f or group 3 as compared with 40.01 to 50.77% for group 2. Mode obliquity was 0.56 to 0.84 among groups. We concluded that herbal remedy increases collagen fibril size of healing rat MCLs homogeneously at 6 weeks posttransection.
Animals↗
[Effect of platelet derived growth factor BB on healing of medial collateral ligament in rats].
OBJECTIVE: To examine an effect of the locally-used platelet derived growth factor-BB (PDGF-BB) on the healing of the medial collateral ligament (MCL) in the knee joints of rats. METHODS: Forty-eight rats were equally randomly divided into 2 groups: the experimental group (group A) and the control group (group B). MCL of all the rats were ruptured to establish the wound models. In group A, 5 microg of PDGF-BB was locally injected in the wound of each rat and then the wound was sutured; but in group B, the wound was only sutured. After 2 weeks, histological evaluations were performed to determine whether PDGF-BB could promote the healing of MCL. RESULTS: There were significantly more fibroblasts formed during the ligament healing process in group A than in group B (213.44 +/- 15.32 vs. 180.42 +/- 12.78, P < 0.01). The fibroblasts were more mature and more regularly-arranged in group A than in group B. The type, content, and crosslink of the collagen were improved to a greater extent in group A than in group B (P < 0.01). CONCLUSION: PDGF can promote the healing of the injured ligament.
Animals↗