Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “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 109 records · Page 6Linked to original sources
PubMed2003

Effect of the angle of the femoral and tibial tunnels in the coronal plane and incremental excision of the posterior cruciate ligament on tension of an anterior cruciate ligament graft: an in vitro study.

BACKGROUND: High tension in an anterior cruciate ligament graft adversely affects both the graft and the knee; however, it is unknown why high graft tension in flexion occurs in association with a posterior femoral tunnel. The purpose of the present study was to determine the effect of the angle of the femoral and tibial tunnels in the coronal plane and incremental excision of the posterior cruciate ligament on the tension of an anterior cruciate ligament graft during passive flexion. METHODS: Eight cadaveric knees were tested. The angle of the tibial tunnel was varied to 60 degrees, 70 degrees, and 80 degrees in the coronal plane with use of three interchangeable, low-friction bushings. The femoral tunnel, with a 1-mm-thick posterior wall, was drilled through the tibial tunnel bushing with use of the transtibial technique. After the graft had been tested in all three tibial bushings with one femoral tunnel, the femoral tunnel was filled with bone cement and the tunnel combinations were tested. Lastly, the graft was replaced in the 80 degrees femoral and tibial tunnels, and the tests were repeated with excision of the lateral edge of the posterior cruciate ligament in 2-mm increments. Graft tension, the flexion angle, and anteroposterior laxity were recorded in a six-degrees-of-freedom load-application system that passively moved the knee from 0 degrees to 120 degrees of flexion. RESULTS: The graft tension at 120 degrees of flexion was affected by the angle of the femoral tunnel and by incremental excision of the posterior cruciate ligament. The highest graft tension at 120 degrees of flexion was 169 +/- 9 N, which was detected with the graft in the 80 degrees femoral and 80 degrees tibial tunnels. The lowest graft tension at 120 degrees of flexion was 76 +/- 8 N, which was detected with the graft in the 60 degrees femoral and 60 degrees tibial tunnels. The graft tension of 76 N at 120 degrees of flexion with the graft in the 60 degrees femoral and 60 degrees tibial tunnels was closer to the tension in the intact anterior cruciate ligament. Excision of the lateral edge of the posterior cruciate ligament in 2 and 4-mm increments significantly lowered the graft tension at 120 degrees of flexion without changing the anteroposterior position of the tibia. CONCLUSIONS: Placing the femoral tunnel at 60 degrees in the coronal plane lowers graft tension in flexion. Our results suggest that high graft tension in flexion is caused by impingement of the graft against the posterior cruciate ligament, which results from placing the femoral tunnel medially at the apex of the notch in the coronal plane.

Adult↗
PubMed2006

Angle between the patellar ligament and tibial plateau in dogs with partial rupture of the cranial cruciate ligament.

OBJECTIVE: To measure the angles between the patellar ligament and the tibial plateau and between the patellar ligament and the common tangent at the tibiofemoral contact point (TFCP) in stifle joints of dogs with partial rupture of the cranial cruciate ligament (CrCL) for comparison with data obtained for stifle joints in dogs with intact CrCLs. SAMPLE POPULATION: 60 stifle joints of 54 dogs with surgically confirmed partial CrCL rupture. PROCEDURES: Mediolateral radiographic views of the stifle joints were obtained, and the angles between the patellar ligament and the conventionally defined tibial plateau (angle gamma) and between the patellar ligament and the common tangent to the TFCP (angle alpha) were measured at incidental stifle joint flexion (angle beta) by 2 independent observers. Data underwent linear regression analysis and were compared with findings in joints of dogs without degenerative joint disease. RESULTS: In stifle joints of dogs with a partial rupture of the CrCL, angles gamma and alpha were 5 degrees and 2 degrees larger than each corresponding angle in healthy canine joints. At 100 degrees of flexion, the patellar ligament was perpendicular to the conventionally defined tibial plateau. At 110 degrees of flexion, the patellar ligament was perpendicular to the common tangent at the TFCP. CONCLUSIONS AND CLINICAL RELEVANCE: In dogs, stifle joints with partially ruptured CrCLs have marginally larger angles between the patellar ligament and the tibial plateau, compared with joints with intact CrCLs; at equivalent angles of flexion, comparatively greater shear force affects the CrCLs in stifle joints with partial CrCL ruptures.

Animals↗
PubMed2005

[Research advance of ligament injury and ligament healing].

OBJECTIVE: To introduce the research advance of the ligament injury and ligament healing. METHODS: Recent original articles related to such aspects of ligament were reviewed extensively. RESULTS: The ligament properties would be influenced when the situations of the biochemistry and biomechanics had changed. Injuries to ligaments induce a healing response that is characterized by scar formation. Graft could not recovery the ultrastructure, anatomy and biomechanics of the normal ligament. CONCLUSION: The healing ligament is weaker than normal one, and the graft could not reconstruct normal ligament at present.

Animals↗
PubMed1991

Reconstruction of the chronically insufficient anterior cruciate ligament with the central third of the patellar ligament.

The results of reconstruction of the anterior cruciate ligament with the central third of the patellar ligament as a free, autogenous, non-vascularized graft were retrospectively reviewed at our institution. Eighty reconstructions in seventy-nine patients were evaluated after a minimum of two years. In forty-eight (60 per cent) of the knees, the reconstruction was augmented with an extra-articular lateral sling of iliotibial band. The patients were evaluated with a physical examination, a KT-1000 arthrometer, radiographs, a subjective questionnaire, and a revision of the scale of The Hospital for Special Surgery for rating ligaments. Postoperatively, seventy-six (95 per cent) of the eighty knees no longer gave way, and the pivot-shift test was negative in sixty-seven (84 per cent) of the knees. The average score on the ligament-rating scale was 93 points. All of the patients who had clinical instability at the time of the most recent follow-up had associated ligamentous instability that had not been appreciated or addressed at the time of reconstruction. Arthrometric evaluation revealed that the laxity differed by three millimeters or less from that of the untreated knee in sixty (76 per cent) of the treated knees. In the patient who had bilateral reconstruction, the laxity was the same in both knees. Seventeen patients, who had more than three millimeters of translation, also had additional related ligamentous instability, most commonly posterolateral instability and insufficiency of the medial collateral ligament. We think that major associated ligamentous instability predisposes the reconstruction to failure and should be corrected in conjunction with the reconstruction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2002

A mechanical comparison of bone-ligament-bone autografts from the wrist for replacement of the scapholunate ligament.

A study was performed to compare the mechanical properties of two intracarpal ligaments with those of the dorsal component of the scapholunate interosseous ligament (SLIL). Trapezoid-to-second metacarpal, capitate-to-trapezoid ligaments, and the dorsal part of the SLIL were obtained as bone-ligament-bone grafts from fresh frozen cadavers. Their respective load to failure and stiffness were measured under uniaxial load on a servohydraulic machine and compared. The capitate-to-trapezoid ligament closely approximated the load to failure and stiffness of the dorsal SLIL, whereas the trapezoid-to-second metacarpal ligament was significantly stronger and stiffer than the dorsal SLIL. These 2 intracarpal bone-ligament-bone grafts share similar mechanical properties with the dorsal component of the scapholunate ligament and might be used clinically to replace it.

Aged↗
PubMedDate not supplied

[Capsular ligament surgery of the knee joint with resorbable materials. 5-year clinical experience with Vicryl and PDS ligaments].

Current methods of capsular ligament surgery of the knee joint are not sufficient stable. Tensions of unloaded movements of the knee joint are appropriate to destruct again the reconstructed capsular ligament mechanism. Immobilisation is required. Additional capsular ligament plastics produced out of absorbable materials (Polyglactin, Polydioxanon) protect safely the reconstructed capsular ligaments from destruction. Early functional treatment is practicable. The ligament plastics seem to stimulate the nature of origin of ligament-similar tissue. The plastic ligaments will be broken down to natural substances byx hydrolysis. An additional surgical excision is not required. Ligament plastics out of Vicryl are recommended.

Humans↗
PubMed1994

Abnormality of the contralateral ligament after injuries of the medial collateral ligament. An experimental study in rabbits.

The right medial collateral ligament of ninety-four adult, female rabbits was transected operatively. At three, six, fourteen, or forty weeks after the operation, the uninjured, contralateral (left) medial collateral ligaments of seventy-eight of the animals were tested biomechanically and compared with the left medial collateral ligaments of thirty-three normal female rabbits. The diameters of the mid-substance collagen fibrils in the medial collateral ligaments were also measured in the uninjured, contralateral hindlimbs of four animals at each interval and compared with the fibril diameters in three normal animals at each of three corresponding intervals. Subtle but significant differences between the uninjured, contralateral and the normal medial collateral ligaments with regard to biomechanical properties of collagen fibril diameters were found at all time-intervals. These results support the notion of a significant effect on the contralateral ligament after an injury to the medial collateral ligament and suggest that contralateral ligaments cannot be considered as a normal control group even in this relatively benign model of knee injury.

Analysis of Variance↗
PubMed1997

Ligament lengthening compared with simple division of the transverse carpal ligament in the open treatment of carpal tunnel syndrome.

It has been suggested that the new (and controversial) endoscopic techniques are more successful than standard operation for the preservation of the ligamentous pulley function across the carpal tunnel and for the separation of the gliding structures from the subcutaneous tissues after release of the carpal ligament in carpal tunnel syndrome. We therefore decided to study the possible importance of preserving the continuity of the carpal ligament by doing an open lengthening of the ligament. This retrospective, unrandomised study included 99 patients with carpal tunnel syndrome who underwent open release of the carpal tunnel with or without a simultaneous lengthening of the transverse carpal ligament. The duration of follow up ranged from 4-8 years. The group who had the ligament lengthened had significantly longer sick leave (p < 0.01) than the group who had transverse ligament section alone. There were no advantages to reconstruction of the transverse ligament.

Adult↗
PubMed1993

Load and length changes in an artificial ligament substitute. 10 cases of anterior cruciate ligament reconstruction.

In 10 patients who had reconstruction of the anterior cruciate ligament, the load and length changes in an artificial ligament substitute were measured during passive knee motion. Using a special drill guide, the ligament was placed within +/- 2 mm of the normal anatomic center on the femur. With the femoral end fixed with a bicortical screw the ligament was preloaded to 40 N at the flexion angle with the shortest intraarticular ligament length, usually 45 degrees. The change in load was then registered from 90 degrees of flexion to full extension. In 2/10 cases loads of > 200 N were registered in full extension, but the mean load was 160 N. There was a higher loss of load during the first extension/flexion cycle than during the 4th cycle. The load change correlated to the length change, but the degree of length change could not predict the maximum load level. There was a large variation in load levels between different knees, even with similar ligament placements, but the least change in load and length was obtained by an anatomic placement. Isometer readings did not predict the load level in the ligament substitute, but could indicate the angle of flexion with minimum load. Therefore, the isometer can be used to control the placement of the attachment points for the substitute. After fixation, fiber settling and stretching the ligament, as well as adaptation of the tissues, will tend to reduce the load levels.

Adult↗
PubMed1984

Biomechanical analysis of human ligament grafts used in knee-ligament repairs and reconstructions.

Virtually all types of collagenous tissues have been transferred in and around the knee joint for intra-articular and extra-articular ligament reconstructions. However, the mechanical properties (in particular, strength) of such grafts have not been determined in tissues from young adult donors, where age and disuse-related effects have been excluded. To provide this information, we subjected ligament graft tissues to high-strain-rate failure tests to determine their strength and elongation properties. The results were compared with the mechanical properties of anterior cruciate ligaments from a similar young-adult donor population. The study indicated that some graft tissues used in ligament reconstructions are markedly weak and therefore are at risk for elongation and failure at low forces. Grafts utilizing prepatellar retinacular tissues (as in certain anterior-cruciate reconstructions) and others in which a somewhat narrow width of fascia lata or distal iliotibial tract is utilized are included in this at-risk group. Wider grafts from the iliotibial tract or fascia lata would of course proportionally increase ultimate strength. The semitendinosus and gracilis tendons are stronger, having 70 and 49 per cent, respectively, of the initial strength of anterior cruciate ligaments. The bone-patellar tendon-bone graft (fourteen to fifteen millimeters wide, medial or central portion) was the strongest, with a mean strength of 159 to 168 per cent of that of anterior cruciate ligaments. Patellar tendon-bone units, based on grip-to-grip motions, were found to be three to four times stiffer than similarly gripped anterior cruciate ligaments, while gracilis and semitendinosus tendon preparations had values that were nearly identical to those of anterior cruciate ligaments.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Results of use of the central one-third of the patellar ligament to compensate for anterior cruciate ligament deficiency.

In a consecutive series of 91 patients with 92 injured knees in which the anterior cruciate ligament was irrevocably destroyed, 79 were males; 12 were females. After a 7-year interval one male patient had surgery on his other knee. Twenty-five of the knees demonstrated isolated injuries to the anterior cruciate ligament, but the incidence of this lesion may be even greater than recorded here. The anterior cruciate ligament was repaired by a patella ligament reconstruction along with other surgical procedures when indicated. There is no acceptable alternative treatment for surgical repair, or substitution for an acutely torn anterior cruciate ligament in the young patient. In the acute or late injury, if the ligament cannot be repaired with sutures, a substitution procedure is indicated. In 92 knees, including 2 revisions, 9 patients were followed for too short a period to warrant evaluation. In 83 knees, the results were: 59 good; 18 fair; 6 poor. The following 5 surgical complications were encountered: 2 wound infections, 2 poorly placed bone plugs, and one ligament was pinched in the intercondylar notch. Until a more satisfactory technique for substitution for a destroyed anterior cruciate ligament is available, the patellar tendon repair procedure is bound to continue to be a useful as well as relatively simple operation.

Female↗
PubMed1997

[Oto-mandibular ligaments: disco-mallear and malleo-mandibular ligaments].

Phylogenesis, embryology and anatomy are emphasizing that two ligaments are found between the temporo-mandibular joint and the middle ear. These two oto-mandibular ligaments are named the disco-mallear ligament and the malleo-mandibular ligament. Originating from the first arch, these ligaments are not involved in the otologic manifestations of the temporo-mandibular joint syndrome. The disco-mallear ligament is a brake applied to the anterior excursion of the disc. When this disco-mallear ligament is stretched the disc can be displaced anteriorly breeding disc displacement, hypermobility and temporo-mandibular dislocation. The malleo-mandibular ligament is a remainder of the Meckel's cartilage: its role is not clear. When excessive forces are applying on the mandible, ossicles dislocation can be seen the forces being transmitted through it.

Branchial Region↗
PubMed1992

[Combined injury of the anterior cruciate ligament and the medial collateral ligament of the knee joint--results of two to six years follow-up of surgical treatment].

A retrospective study of 148 combined acute knee injuries with anterior cruciate and medial collateral ligament injuries was performed. Follow-up included 115 patients, 95 of whom were personally examined two to six years postoperatively. Proximal anterior cruciate ligament ruptures were treated with reinsertion in 96 patients, in case of intraligamentous lesions (44 times), augmentation with the semitendinosus tendon was performed. Medial collateral ligament lesions were explored during the operation. Reconstruction of intraligamentous ruptures was performed with sutures (120 times). Distal lesions were refixed with Burri plate or staple. A modified Ellison procedure was routinely performed. Postoperative treatment was cast-free and included immediate physiotherapy using a functional brace. Between the two groups with anterior cruciate ligament reinsertion and augmentation, no significant differences were observed in subjective evaluation (Lysholm score 85 vs. 88), activity level (Tegner score 5.5 vs. 5.4) or anterior stability (KT 1000 at 89 N 6.6 vs. 6.1 mm displacement). A clear pivot shift sign was noted in two knees with reinsertion and in none of the augmented group. Medial stability was reestablished almost completely, independent of the site of lesion or the reconstruction technique (average valgus movement at 30 degrees flexion 0.7+ vs. 0.5+ on injured/contralateral side). We conclude that reinsertion of femoral anterior cruciate ligament ruptures will reestablish anterior stability in most cases, although semitendinosus augmentation appears to give slightly more reliable results. Medial stability is gained by the site-depending reconstruction techniques. Whether intraligamentous medial collateral ligament lesions can be left alone with only the anterior cruciate ligament being reconstructed, cannot be answered by this study.

Adolescent↗
PubMedDate not supplied

Reconstruction of the lateral collateral ligament of the knee with patellar tendon allograft. Report of a new technique in combined ligament injuries.

This is a retrospective study of 10 patients with combined cruciate ligament and posterolateral instability who underwent surgical reconstruction between 1991 and 1994. All knees had at least 20 degrees increased external rotation at 30 degrees of knee flexion and from 1+ to 3+ varus instability. Five knees with posterior cruciate ligament ruptures had at least a 2+ Lachman test result. (One knee had both anterior and posterior cruciate ligament injuries). In all cases the lateral collateral ligament was reconstructed with a bone-patellar tendon-bone allograft secured with interference screws. Fixation tunnels were placed in the fibular head and at the isometric point on the femur. The cruciate ligaments were reconstructed with autograft or allograft material. The average follow-up was 28 months. Excessive external rotation at 30 degrees of flexion was corrected in all but one knee. Six patients had no varus laxity, and four patients had 1+ varus laxity at 30 degrees of flexion. The posterior drawer test result decreased, on average, to 1+, and the Lachman test result decreased to between 0 and 1+. The average Tegner score was 4.6, with five patients returning to their preinjury level of activity and four returning to one level lower. These results indicate that this is a promising new procedure for patients with instability resulting from lateral ligament injuries of the knee.

Adult↗
PubMed1993

Five-year results of anterior cruciate ligament reconstruction with the Stryker Dacron high-strength ligament.

Forty-two consecutive patients (27 male and 15 female, with a mean age of 26 years) suffering from unilateral chronic anterior cruciate ligament insufficiency underwent surgical reconstruction with a Dacron high-strength ligament (Stryker). In 32 patients the synthetic ligament was used as a reinforcement in an iliotibial band intra-articular procedure and in 10 patients as an intra-articular prosthesis without biological reinforcement. There were 24 concomitant injuries such as meniscal tears, status post-meniscectomy or medial collateral ligament insufficiency at the time of reconstruction. The initial injury occurred during soccer in 23 patients and other pivoting sports in 16 patients. Two and 5 years after reconstruction, the patients underwent clinical examination, including the instrumented knee laxity test (OSI), and performed subjective evaluation. The anterior tibial translation was 6.3 +/- 2.6 mm greater than in the healthy knee, the mean Lysholm score was 78 points, and the Tegner activity score was lower than its pre-injury level. Radiography revealed that 31 of 37 ligaments had ruptured and another 2 ligaments showed more than 5 mm side-to-side increased laxity. The Stryker Dacron high-strength ligament ruptured in more than 80% of the cases and patients could not return to their pre-injury physical performance activities.

Adult↗
PubMed1996

Arthroscopic reconstruction of the anterior cruciate ligament with Leeds-Keio ligament in non-professional athletes. Results after a minimum 5 years' follow-up.

We report our experience using the Leeds-Keio artificial ligament for anterior cruciate ligament (ACL) reconstruction. The study relates the results of the first 40 patients subjected to arthroscopic reconstruction of the ACL with a Leeds-Keio ligament, with a mean follow-up of 73 months. No associated peripheral procedures were carried out on any patient. The average age of the patients at the time of the operation was 31 years (range 26-35 years). The rehabilitation protocol followed by all patients aimed at resumption of sport 4 months after the operation. Clinical assessment included IKDC and the Lysholm scoring scale. The KT-2000 system was used for instrumented evaluation of joint laxity. All patients underwent a radiographic check-up. Clinically there were 55% excellent or good results when using the IKDC scale, while with the Lysholm score, satisfactory results were obtained in 80%. Complete post-traumatic rupture of the ligament was observed in three patients. No patient suffered an episode of either hydrarthrosis or reactive synovitis, which indicates good tolerance to the ligament. The radiographic evaluation of the operated knees showed a close correlation between the appearance of degenerative phenomena and performance of arthroscopic meniscectomy. The results achieved with the Leeds-Keio artificial ligament 5 years after application, although not completely satisfactory and inferior to those obtained with autologous biological ligaments, should be considered an encouragement to promote new efforts in this interesting research field.

Adolescent↗
PubMed1995

[Affinity of estrogen binding in the cultured spinal ligament cells: an in vitro study using cells from spinal ligament ossification patients].

This immunological study investigated the effects of estrogen as a potential causative factor for spinal ligament ossification (such as ossification of the posterior longitudinal ligament, OPLL; ossification of the yellow ligament, OYL; and ossification of the anterior longitudinal ligament, OALL). The serum total estrogen (estron + estradiol + estriol) level in the OPLL patients and controls was measured by radioimmunoassay. To determine any difference in the affinity of the estrogen, 3,17 beta-estradiol receptors of cultured spinal ligament cells obtained from OPLL patient were detected by receptor binding assay, and compared with cells from controls. Additionally, to evaluate the responses of cultured spinal ligament cells to stimulation by 3,17 beta-estradiol, examined the production of bone Gla protein (BGP) in medium, the rate of tritiated thymidine (3H-TdR) uptake, and change in affinity of transforming growth factor-beta 1 (TGF-beta 1) receptor on those cells with 3,17 beta-estradiol added (E2+ group), and compared the results with those when 3,17 beta-estradiol was not added (E2- group). The serum total estrogen level was significantly higher in OPLL patients than in controls, and the level increased with increasing extent of ligament ossification. Cultured cells obtained from OPLL patients had receptors with a higher affinity for 3,17 beta-estradiol than did cells from controls. Cells obtained from OPLL patients responded to the stimulation by 3,17 beta-estradiol, accelerated BGP production, and elevated the 3H-TdR uptake. However, cells from controls showed no change in the stimulation by 3,17 beta-estradiol.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2004

["Shrinkage of cruciate ligaments"--a biomechanical study. Shrinkage of elongated cruciate ligaments using an application of radiofrequency energy].

The aim of this study was to evaluate structural properties of native and elongated bovine anterior cruciate ligaments after the application of bipolar radiofrequency. Using a material testing machine typical load-elongation curves were used to determine the initial strength of untreated (group 1, n = 20) and elongated cruciate ligaments (group 2, n = 20) after treatment with bipolar radiofrequency (ArthroCare). After the application of a cyclic loading protocol (1000 x 400 N) elongation, yield load, maximal load, and stiffness were determined. Native ligaments served as a control group (group 3, n = 20). In both groups 4 mm reduction in length was caused by the application of radiofrequency. Elongation was significantly higher; yield load, maximal load, and stiffness of cruciate ligaments treated with radiofrequency (groups 1 and 2) were significantly reduced after the application of a cyclic loading protocol in comparison to the control group (p < 0.05). Group 2 ligaments showed the lowest values. The application of radiofrequency weakens the biomechanical properties of native and elongated cruciate ligaments significantly. When radiofrequency energy is used to shrink elongated cruciate ligaments, a nonaggressive rehabilitation protocol should be applied.

Animals↗