Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Collateral Ligaments”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
PubMed2005

The change in length of the medial and lateral collateral ligaments during in vivo knee flexion.

The collateral ligaments of the knee are important in maintaining knee stability. However, little data has been reported on the in vivo function of the collateral ligaments. The objective of this study was to investigate the change in length of different fiber bundles of the medial collateral ligament (MCL), deep fibers of the MCL (DMCL) and the lateral collateral ligament (LCL) during in vivo knee flexion. The knees of five healthy subjects were scanned using magnetic resonance imaging. These images were used to create three-dimensional models of the tibia and femur, including the insertions of the collateral ligaments. The MCL, DMCL, and LCL were each divided into three equal portions: an anterior bundle, a middle bundle and a posterior bundle. Next, the subjects were imaged from two orthogonal directions using fluoroscopy while performing a quasi-static lunge for 0 degree to 90 degrees of flexion. The models and fluoroscopic images were then used to reproduce the in vivo motion of the knee. From these models, the length of each bundle of each ligament was measured as a function of flexion. The length of the anterior bundle of the MCL did not change significantly with flexion. The length of the posterior bundle of the MCL consistently decreased with flexion (p less than 0.05). The changes in deformation of the DMCL and LCL as a function of flexion were similar to each other. The length of the anterior bundles increased with flexion and the length of the posterior bundles decreased with flexion. These data indicate that the collateral ligaments do not elongate uniformly as the knee is flexed, with different bundles becoming taut and slack. These data may help to provide a better understanding of the in vivo function of the collateral ligaments and be used to improve surgical reconstruction of the collateral ligaments. Furthermore, the data suggest that the different roles of various portions of the collateral ligaments along the flexion path should be considered before releasing the collateral ligaments during knee arthroplasty.

Adult↗
PubMed1994

MR imaging of the ankle: normal and abnormal findings in the medial collateral ligament.

The medial collateral ligament (MCL) of the ankle, also known as the deltoid ligament, attaches the medial malleolus to the tarsus. There are almost as many different descriptions of the components of the MCL as there are people describing them. Differences exist as to whether it has superficial and deep components, which ligaments are superficial and which are deep, the attachment sites of the component ligaments, and even the number and names of component ligaments [1]. Additionally, evaluation of the MCL on MR images has been largely ignored. This pictorial essay illustrates the normal component ligaments of the MCL, as well as injuries to each of these components, as seen on three-dimensional Fourier transform (3DFT) gradient-recalled echo (GRE) MR images in 81 patients (86 ankles).

Adult↗
PubMed2001

Strain in the human medial collateral ligament during valgus loading of the knee.

The medial collateral ligament is one of the most frequently injured ligaments in the knee. Although the medial collateral ligament is known to provide a primary restraint to valgus and external rotations, details regarding its precise mechanical function are unknown. In this study, strain in the medial collateral ligament of eight knees from male cadavers was measured during valgus loading. A material testing machine was used to apply 10 cycles of varus and valgus rotation to limits of +/- 10.0 N-m at flexion angles of 0 degrees, 30 degrees, 60 degrees, and 90 degrees. A three-dimensional motion analysis system measured local tissue strain on the medial collateral ligament surface within 12 regions encompassing nearly the entire medial collateral ligament surface. Results indicated that strain is significantly different in different regions over the surface of the medial collateral ligament and that this distribution of strain changes with flexion angle and with the application of a valgus torque. Strain in the posterior and central portions of the medial collateral ligament generally decreased with increasing flexion angle, whereas strain in the anterior fibers remained relatively constant with changes in flexion angle. The highest strains in the medial collateral ligament were found at full extension on the posterior side of the medial collateral ligament near the femoral insertion. These data support clinical findings that suggest the femoral insertion is the most common location for medial collateral ligament injuries.

Cadaver↗
PubMed2003

Avulsion fracture of the posterior oblique ligament associated with acute tear of the medial collateral ligament.

The term posterior oblique ligament was proposed in 1973 but the specific anatomy of this region has been controversial. It has been concluded that the posterior oblique ligament is separated from the medial collateral ligament, each with distinctly different bony attachment points. In this article, we report a posterior oblique ligament avulsion fracture associated with a medial collateral ligament rupture.

Accidents, Traffic↗
PubMed1985

Effects of joint load on the stiffness and laxity of ligament-deficient knees. An in vitro study of the anterior cruciate and medial collateral ligaments.

We measured the effects of serial section of the medial collateral ligament and anterior cruciate ligament and of the anterior cruciate ligament and medial collateral ligament on anterior-posterior force-versus-displacement and tibial torque-versus-rotation response curves for seven fresh frozen cadaver knees at zero and 20 degrees of flexion before and after application of as much as 925 newtons of compressive load on the tibiofemoral joint. Section of the anterior cruciate ligament always increased anterior laxity in an unloaded specimen; joint load reduced this increase by a greater amount at zero degrees than at 20 degrees of flexion. Joint load was more effective in limiting anterior laxity in anterior cruciate-deficient specimens at low levels of applied anterior force; at higher levels of applied force, the effects of joint congruency were overcome and ligament restraints came into play. Section of the medial collateral ligament increased anterior laxity in an unloaded knee only for specimens in which the anterior cruciate ligament had been previously sectioned; joint load eliminated this increase at full extension but did not do so at 20 degrees of flexion. The medial collateral ligament was the more important of the two ligaments in controlling torsional laxity. Secondary section of either ligament (the other ligament having been sectioned first) produced a greater increase in laxity than did primary section of that ligament in an intact knee. Increases in torsional laxity due to primary section of either ligament were unaffected by the application of joint load. Joint load reduced increases in laxity that were due to secondary section of the medial collateral ligament.

Aged↗
PubMed1998

Anatomy of the collateral ligaments of the human ankle joint.

Damage to the collateral ligaments of the ankle is relatively common, particularly the lateral ligaments; therefore, it is important to be aware of the detailed anatomy and frequency of variation of the individual ligaments. Only two reports of collateral ligaments dimensions were found in the literature, neither of which considers all of the individual components of the collateral ligament complex. Osteoligamentous preparations of the collateral ligaments of 40 ankles from 20 cadavers of European Caucasian origin were studied, from which mean values for the length and width of the individual components were determined, together with their frequency of occurrence. For the collateral ligaments of the ankle as a whole, the ligamentous dimensions determined in this study are similar to those reported previously. The data presented in this study are, therefore, a valuable addition to the small pool of data that exists concerning the dimensions of the collateral ligaments of the human ankle joint. These data may be of value when considering surgical repair or reconstruction of traumatized collateral ligaments, especially because any undue foreshortening of the ligaments may reduce the range of motion possible at either the ankle or subtalar joints, or both. It is possible that in extreme cases, such a reduction in the range of motion may modify gait patterns and the transmission of stresses across the joints of the foot and lower limb.

Aged↗
PubMed2006

Morphological, biochemical and mechanical features of the cranial cruciate and lateral collateral ligaments in dogs.

The cruciate ligament and the collateral ligament play key roles in stabilization of the knee joint. Cases of serious knee joint problems presented at the, the Veterinary Teaching Hospital of Rakuno Gakuen University, Japan mostly involved rupture of the cranial cruciate ligament (CCL). Disorders in structural and biochemical components of the CCL were thought to be the causes of the knee problems. Morphological, biochemical and biomechanical features of the CCL and the lateral collateral ligament (LCL) were therefore analyzed. In the CCL, fibroblasts with ovoid and enlarged nuclei were observed mainly at the periphery of collagen bundles. The array of collagen fibrils in the LCL was slightly disoriented, but that of the CCL was tight and regular. In the LCL, the major groups of collagen fibrils were those with diameters of 70-80 and 120-130 nm. Most collagen fibrils in the CCL had diameters of 70-80 nm. The mean collagen diameters were 90 nm in the CCL and 105 nm in the LCL. The ratios of the noncollagen area to the area occupied by collagen fibrils were 43% in the CCL and 55% in the LCL. There was no difference between the amounts of HA or between the amounts of DS in two ligaments. However, the amount of CS in the CCL was about 17-times greater than that in the LCL. The expansion of and the resistance to tension exerted onto the CCL were less than those of the LCL. A high concentration of CS and low tensile strength due to small-sized collagen fibrils cause the CCL to rupture easily, especially when overextension of the knee joint occurs.

Animals↗
PubMed1991

MR imaging of the lateral collateral ligament of the ankle.

The ankle is stabilized by three sets of ligaments: the medial collateral (deltoid) ligament, the syndesmotic ligamentous complex, and the lateral collateral ligament. Of these three, the lateral collateral ligament is the one most often injured in ankle sprains. Assessment of the extent of injury has classically relied on clinical evaluation; plain film radiographs (including stress views); and, in some acute situations, ankle arthrography and/or peroneal tenography. In this report we illustrate the use of MR in the evaluation of the lateral collateral ligament. The normal anatomy, pitfalls in image interpretation, and findings in cases of ligamentous injury are demonstrated.

Ankle Joint↗
PubMed1997

Physiological and mechanical adaptations of rabbit medial collateral ligament after anterior cruciate ligament transection.

Progressive physiological and mechanical changes in the medial collateral ligament of the adult rabbit were investigated for as long as 48 weeks after disruption of the anterior cruciate ligament. Eighty-one New Zealand White rabbits were separated into experimental, sham-operated control, and normal control groups. The experimental group underwent unilateral transection of the right anterior cruciate ligament, sham-operated animals served as controls for comparison, and normal animals were evaluated as age-matched, undisturbed (no surgery) controls. Blood flow to the medial collateral ligament (as a physiological measure) and mechanical function (structural and material properties) were assessed at 6, 14, and 48 weeks. The results indicated that loss of the anterior cruciate ligament leads to early mechanical deterioration of the medial collateral ligament with a corresponding loss of physiological homeostasis. Six to 14 weeks after the transection, values for cross-sectional area of the medial collateral ligaments rapidly increased to 1.5 times control values. The ligament became twice as large as the control ligament by 48 weeks. Concomitantly, medial collateral ligament stress at failure of the medial collateral ligament complex decreased rapidly 6-14 weeks after the transection and eventually fell to one-half that of controls by 48 weeks. In terms of low-load behaviour, laxity and load relaxation were significantly greater than that of controls 6 weeks after transection and were further increased by 14 weeks. By 48 weeks, laxity values had recovered somewhat and load-relaxation measures had recovered to near control values. At both 6 and 14 weeks, a statistically significant elevation in blood flow was demonstrated compared with controls. By 48 weeks, however, blood flow was no different from that of the sham-operated control. Thus, early after transection of the anterior cruciate ligament, both low-load and high-load mechanical properties of the medial collateral ligament deteriorated and the rate of blood flow was temporarily elevated. By 48 weeks, blood flow declined to near control values, with a corresponding recovery in viscoelastic behaviour. These findings suggest that, after transection of the anterior cruciate ligament, viscoelastic behaviour of the medial collateral ligament may be related to changes in blood flow and that restoration of normal flow patterns and vascular responses may be linked to the recovery of some low-load mechanical properties in the anterior cruciate ligament-deficient medial collateral ligament.

Adaptation, Physiological↗
PubMed1995

Effects of a delayed steroid injection on ligament healing using a rabbit medial collateral ligament model.

Corticosteroids are known to inhibit collagen synthesis in vitro as well as having a deleterious effect on ligament healing when applied immediately following injury. An acute injection of betamethasone into a transected rabbit medial collateral ligament significantly impaired the biomechanical and histological properties compared to non-injected transected ligaments. Differences in mechanical, histological and biochemical properties were observed up to 3 months following injury and an acute steroid injection. The present study explored the effects of a corticosteroid (betamethasone) injection 7 days following the initial injury. Biomechanical and histomorphometric analyses were carried determine if the previously observed deleterious effects of a corticosteroid injection immediately following injury can be linked to an interference in the inflammatory phase of healing due to the presence of the corticosteroid.

Analysis of Variance↗
PubMed1994

Ulnar collateral ligament of the thumb: MR findings in cadavers, volunteers, and patients with ligamentous injury (gamekeeper's thumb).

OBJECTIVE: The ulnar collateral ligament bridges the ulnar aspect of the first metacarpal and the proximal phalanx and functions as a major stabilizer of the first metacarpophalangeal joint. Acute or chronic injury of this ligament is referred to as gamekeeper's thumb. The objectives of this study were to (1) determine the MR appearance of the ulnar collateral ligament of the thumb in cadavers and volunteers and (2) analyze the MR findings in patients with gamekeeper's thumb, especially with regard to the value of MR in detecting clinically significant displacement of the ligament (Stener lesion). MATERIALS AND METHODS: MR imaging of the first metacarpophalangeal joint was performed in three volunteers, two cadaveric specimens, and 11 patients with acute injury. In the patients, the mechanism of injury was an abrupt abductive force on the thumb resulting in rupture of the ulnar collateral ligament. The diagnosis was confirmed by surgery in five patients and by clinical follow-up in the remaining six. Cryomicrotome sectioning of the cadaveric tissue blocks was performed to correlate pathologic and MR findings. Images were interpreted by one radiologist. RESULTS: MR images showed rupture of the ulnar collateral ligament in all 11 patients. Prospectively, Stener lesions (n = 3) could be differentiated from non-Stener lesions (n = 8) in eight of 11 patients. Retrospectively, the correct diagnosis could be made in all 11 patients once the importance of determining the position of the ulnar collateral ligament relative to the adductor aponeurosis was understood. CONCLUSION: MR imaging of the first metacarpophalangeal joint depicts the ulnar collateral ligament and adductor aponeurosis to good advantage. It can also accurately show tears of the ulnar collateral ligament and thus be used to differentiate a rupture without significant retraction from a Stener lesion. This information is important in determining whether surgical or conservative management is indicated.

Collateral Ligaments↗
PubMed1984

Functional anatomy of the equine tarsocrural collateral ligaments.

Equine tarsocrural collateral ligaments (CL) were dissected grossly. The areas of attachment and fiber arrangements were described for the long lateral CL, long medial CL, 3 short lateral CL, and 3 short medial CL. Sequential cutting of CL in any order indicated that the short medial CL were responsible for the snap-joint phenomenon observed at the equine tarsocrural joint.

Animals↗
PubMed1993

Ligament replacement for chronic instability of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb.

Static and dynamic procedures have been described for reconstruction of chronic instability of the ulnar collateral ligament of the thumb metacarpophalangeal joint. This study presents a technique of ligament replacement utilizing a free tendon graft passed through two gouge tracks in the proximal phalanx and one in the metacarpal in a manner that closely approximates normal anatomy. We retrospectively reviewed 26 patients who underwent replacement. The follow-up period averaged 4.5 years. In 24 of 26 cases the joint was rendered stable by the replacement and the patient was relieved of pain. Eighty-five percent of the arc of motion was maintained. Postoperative key pinch measured 20 lb. on the operated side compared to 21 lb. on the unoperated side. Results were excellent in 20 patients, good in 4, and fair in 2. This technique successfully restores stability to the ulnar collateral ligament of the thumb metacarpophalangeal joint, diminishes pain and weakness with minimal loss of motion, and holds up over time.

Adult↗
PubMed1998

Primary reconstruction of the medial collateral ligament in combined injury of the medial collateral and anterior cruciate ligaments. Short-term results.

We describe our experiences with 22 patients who underwent acute surgical intervention for complete combined injury of the anterior cruciate ligament (ACL) and medial collateral ligament (MCL) in our hospital. In all patients, an arthroscopically guided repair of the MCL was performed, while the torn ACL was treated non-surgically. Primary reconstruction of the MCL in patients with complete disruptions of the MCL complex as well as the ACL reduces combined anteromedial instability to an isolated problem of the ACL. As a result of this treatment, the condition of 15 of 22 knees was improved, after an average duration of follow-up of 2 and a half years. In conclusion, our treatment strategy of an immediate repair of the MCL and reconstruction of the ACL when conservative treatment has failed seems safe and effective.

Adolescent↗
PubMedDate not supplied

Does nitric oxide help explain the differential healing capacity of the anterior cruciate, posterior cruciate, and medial collateral ligaments?

This study compared the ability of rabbit medial collateral ligament, posterior cruciate ligament, and anterior cruciate ligament tissue to synthesize nitric oxide, and determined its effects on matrix synthesis, an important component of ligament repair. It is not known whether ligament cells can produce nitric oxide and, if so, whether it influences healing of ligament injuries. The anterior cruciate and posterior cruciate ligament tissue produced large amounts of nitric oxide in response to the inflammatory cytokine interleukin-1. Medial collateral ligament, in contrast, produced only modest amounts of nitric oxide. Furthermore, anterior cruciate ligament and, to some degree, posterior cruciate ligament synthesized nitric oxide spontaneously in culture, whereas medial collateral ligament never did so. When nitric oxide was supplied to these tissues, it strongly inhibited collagen synthesis by the two cruciate ligaments, but had little effect on collagen synthesis by the medial collateral ligament. Endogenously synthesized nitric oxide was also able to inhibit collagen synthesis as well as proteoglycan synthesis by the two cruciate ligaments, but had little effect on matrix synthesis by the medial collateral ligament. We propose a novel hypothesis, based on nitric oxide production and matrix synthesis, that may help explain why the two cruciate ligaments have such limited healing capacity compared with the medial collateral ligament.

Animals↗
PubMedDate not supplied

The appearance of the lateral ulnar collateral ligament on magnetic resonance imaging.

The lateral ulnar collateral ligament is an important element of the elbow's lateral capsuloligamentous complex, and loss of integrity contributes to posterolateral rotatory instability. However, the normal appearance on magnetic resonance imaging is poorly defined. The purpose of this study was to assess the appearance of the lateral ulnar collateral ligament of asymptomatic elbows on magnetic resonance imaging. We performed magnetic resonance imaging on 20 asymptomatic elbows. The lateral ulnar collateral ligament was identified as a hypointense structure originating from the lateral epicondyle and inserting on the proximal ulna in 10 cases (50%) and was ambiguous in the other 10 elbows. The identified lateral ulnar collateral ligament images included areas of high signal intensity, which was confusing because it suggested ligamentous disruption within the ligament. These results indicate that magnetic resonance imaging is not reliable for diagnosing lateral ulnar collateral ligament injuries at the present time. Further progress in magnetic resonance imaging will be clinically useful for diagnosing abnormalities of the lateral ulnar collateral ligament.

Adult↗
PubMed2005

Anatomy of the collateral ligaments of the proximal interphalangeal joint.

PURPOSE: To study and clarify the anatomy of the proper collateral ligaments and accessory collateral ligaments of the proximal interphalangeal joint. METHODS: The collateral ligaments of 8 proximal interphalangeal joints were dissected under an operating microscope to gain an appreciation of their fiber direction and the anatomy of their origin and insertion. Two undissected joints were studied histologically. RESULTS: The proper collateral ligament was found to arise widely from dorsal and proximal to and from the fovea on the side of the head of the proximal phalanx and insert for some distance on most of the side of the base of the middle phalanx. The ligament is stout and its fibers are oriented parallel to the middle phalanx in all positions of the joint. The accessory collateral ligament was found to be a less substantial structure lying between the proper collateral ligament and the volar plate. CONCLUSIONS: The anatomy shown by this study is quite different from that shown in most of the anatomic and hand surgery literature, particularly in line drawings.

Cadaver↗
PubMed2005

Ligamentous versus physeal failure in murine medial collateral ligament biomechanical testing.

This study examines the age at which a femoral physeal failure ceased to occur in a mouse model of medial collateral ligament (MCL) testing. Biomechanical testing of the MCL with load to failure can result in physeal failure rather than MCL failure in skeletally immature animals. Failure mode depended significantly on age (p<0.05). Sixty percent of the knees tested at 4 months failed at the physis rather than at the ligament, whereas, only ten percent of the knees tested at 5 and 6 months failed at the physis. The mean ultimate force to failure for the specimens in which the failure occurred at the ligament was 8.1 N with a higher values for the right side versus the left (p<0.05). For the specimens in which the failure occurred at the physis, the mean ultimate force to failure was 11.2 N. We now consider that 5 month old mice are functionally skeletally mature and old enough to be tested biomechanically with few failures at the physis.

Age Factors↗