In the published literature as well as in the most commonly used textbooks, the lateral collateral ligament (LCL) is described as having 1 attachment at the lateral epicondyle of the femur and another at the head of t...In the published literature as well as in the most commonly used textbooks, the lateral collateral ligament (LCL) is described as having 1 attachment at the lateral epicondyle of the femur and another at the head of the fibula. In this article, we reconsider the attachments, the length of the LCL, and the tissues surrounding the LCL by presenting our anatomical observations and by reviewing the literature. Our results have shown that the LCL is not only attached to the lower part of the lateral epicondyle of the femur, but also extends to the upper part of the lateral epicondyle. The attachment of the LCL on the fibula is enclosed by 2 insertion points of the biceps femoris tendon. The average length of the LCL in 71 knees was 51.4 mm. There is an “incomplete gap” on the LCL that is interrupted under the tendon of the biceps femoris.展开更多
Medial collateral ligament of the knee is an important coronal stabiliser and often injured in isolation or as combination of injuries. The article reports a case of incarcerated medial collateral ligament (MCL) inj...Medial collateral ligament of the knee is an important coronal stabiliser and often injured in isolation or as combination of injuries. The article reports a case of incarcerated medial collateral ligament (MCL) injury in combination with anterior cruciate ligament (ACL) injury in 20 year old male who presented to us 4 weeks after injury. Clinical examination and MRI was correlated to complete ACL tear with torn distal MCL and incarceration into the joint. Patient was taken up for ACL hamstring graft reconstruction with mini-arthrotomy and repair of the torn MCL. Patient was followed up with dedicated rehabilitation protocol with good functional results. At one year follow-up, patient exhibited full range of motion with negative Lachman, Pivot shift and valgus stress tests. This article highlights the rare pattern of MCL tear and also reviews the literature on this pattern of injury.展开更多
This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft ...This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft fixation techniques.The paper explores and comments on a recently published review by Dai et al,titled"Research progress on preparation of lateral femoral tunnel and graft fixation in ACLR",while providing insight into its relevance within the field of ACLR,and recommendations for future research.展开更多
Objective: To create a 3-dimensional finite element model of knee ligaments and to analyse the stress changes of lateral collateral ligament (LCL) with or without displaced movements at different knee flexion condi...Objective: To create a 3-dimensional finite element model of knee ligaments and to analyse the stress changes of lateral collateral ligament (LCL) with or without displaced movements at different knee flexion conditions. Methods: A four-major-ligament contained knee specimen from an adult died of skull injury was prepared for CT scanning with the detectable ligament insertion footprints, locations and orientations precisely marked in advance. The CT scanning images were converted to a 3-dimensional model of the knee with the 3-dimensional reconstruction technique and transformed into finite element model by the software of ANSYS. The model was validated using experimental and numerical results obtained by other scientists. The natural stress changes of LCL at five different knee flexion angles (0°, 30°60°, 90°, 120°) and under various motions of anterior-posterior tibial translation, tibial varus rotation and internal-external tibial rotation were measured. Results: The maximum stress reached to 87%-113% versus natural stress in varus motion at early 30° of knee flexions. The stress values were smaller than the peak value of natural stress at 0° (knee full extension) when knee bending was over 60° of flexion in anterior-posterior tibial translation and internal-external rotation. Conclusion: LCL is vulnerable to varus motion in almost all knee bending positions and susceptible to ante- rior-posterior tibial translation or internal-external rotation at early 30° of knee flexions.展开更多
BACKGROUND Simple lateral elbow dislocation(SLED)is a rare type of elbow dislocation;however,its treatment may be complicated by accompanying soft tissue or neurovascular damage.Herein,we report a rare case of SLED ma...BACKGROUND Simple lateral elbow dislocation(SLED)is a rare type of elbow dislocation;however,its treatment may be complicated by accompanying soft tissue or neurovascular damage.Herein,we report a rare case of SLED managed secondarily with open reduction and soft tissue repair following failure of closed reduction.CASE SUMMARY A 67-year-old woman suffered SLED after falling on her outstretched left hand with her elbow extended.She developed pain,swelling,and movement restriction in the elbow;there were no neurovascular symptoms,except for numbness in the 4th and 5th digits.Radiologic investigation confirmed the SLED,and a closed reduction under anesthesia was performed.The follow-up radiographs at 1-wk revealed failure of reduction;accordingly,open reduction with lateral collateral ligament and common extensor origin repair were carried out.The patient regained full elbow range of motion by six weeks.CONCLUSION Adequate concentric reduction for SLED,conservatively or surgically,reduces complications and provides a more functional joint.展开更多
文摘In the published literature as well as in the most commonly used textbooks, the lateral collateral ligament (LCL) is described as having 1 attachment at the lateral epicondyle of the femur and another at the head of the fibula. In this article, we reconsider the attachments, the length of the LCL, and the tissues surrounding the LCL by presenting our anatomical observations and by reviewing the literature. Our results have shown that the LCL is not only attached to the lower part of the lateral epicondyle of the femur, but also extends to the upper part of the lateral epicondyle. The attachment of the LCL on the fibula is enclosed by 2 insertion points of the biceps femoris tendon. The average length of the LCL in 71 knees was 51.4 mm. There is an “incomplete gap” on the LCL that is interrupted under the tendon of the biceps femoris.
文摘Medial collateral ligament of the knee is an important coronal stabiliser and often injured in isolation or as combination of injuries. The article reports a case of incarcerated medial collateral ligament (MCL) injury in combination with anterior cruciate ligament (ACL) injury in 20 year old male who presented to us 4 weeks after injury. Clinical examination and MRI was correlated to complete ACL tear with torn distal MCL and incarceration into the joint. Patient was taken up for ACL hamstring graft reconstruction with mini-arthrotomy and repair of the torn MCL. Patient was followed up with dedicated rehabilitation protocol with good functional results. At one year follow-up, patient exhibited full range of motion with negative Lachman, Pivot shift and valgus stress tests. This article highlights the rare pattern of MCL tear and also reviews the literature on this pattern of injury.
文摘This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft fixation techniques.The paper explores and comments on a recently published review by Dai et al,titled"Research progress on preparation of lateral femoral tunnel and graft fixation in ACLR",while providing insight into its relevance within the field of ACLR,and recommendations for future research.
文摘Objective: To create a 3-dimensional finite element model of knee ligaments and to analyse the stress changes of lateral collateral ligament (LCL) with or without displaced movements at different knee flexion conditions. Methods: A four-major-ligament contained knee specimen from an adult died of skull injury was prepared for CT scanning with the detectable ligament insertion footprints, locations and orientations precisely marked in advance. The CT scanning images were converted to a 3-dimensional model of the knee with the 3-dimensional reconstruction technique and transformed into finite element model by the software of ANSYS. The model was validated using experimental and numerical results obtained by other scientists. The natural stress changes of LCL at five different knee flexion angles (0°, 30°60°, 90°, 120°) and under various motions of anterior-posterior tibial translation, tibial varus rotation and internal-external tibial rotation were measured. Results: The maximum stress reached to 87%-113% versus natural stress in varus motion at early 30° of knee flexions. The stress values were smaller than the peak value of natural stress at 0° (knee full extension) when knee bending was over 60° of flexion in anterior-posterior tibial translation and internal-external rotation. Conclusion: LCL is vulnerable to varus motion in almost all knee bending positions and susceptible to ante- rior-posterior tibial translation or internal-external rotation at early 30° of knee flexions.
文摘BACKGROUND Simple lateral elbow dislocation(SLED)is a rare type of elbow dislocation;however,its treatment may be complicated by accompanying soft tissue or neurovascular damage.Herein,we report a rare case of SLED managed secondarily with open reduction and soft tissue repair following failure of closed reduction.CASE SUMMARY A 67-year-old woman suffered SLED after falling on her outstretched left hand with her elbow extended.She developed pain,swelling,and movement restriction in the elbow;there were no neurovascular symptoms,except for numbness in the 4th and 5th digits.Radiologic investigation confirmed the SLED,and a closed reduction under anesthesia was performed.The follow-up radiographs at 1-wk revealed failure of reduction;accordingly,open reduction with lateral collateral ligament and common extensor origin repair were carried out.The patient regained full elbow range of motion by six weeks.CONCLUSION Adequate concentric reduction for SLED,conservatively or surgically,reduces complications and provides a more functional joint.
文摘目的:比较体外冲击波疗法(extracorporeal shockwave therapy,ESWT)联合传统治疗和单纯传统治疗对膝内侧副韧带陈旧性损伤患者的效果。方法:回顾性分析2019年11月—2022年1月在珠海市第五人民医院治疗的85例膝内侧副韧带陈旧性损伤患者,根据治疗方案不同分组,其中对照组41例予以传统治疗,治疗组44例予以ESWT联合传统治疗。评估患者治疗前、治疗后和随访时的疼痛视觉模拟评分法(visual analog scale,VAS)评分、膝关节活动度、Lysholm膝关节评分和疗效。结果:在治疗后及随访时,两组患者在VAS评分、膝关节活动度、Lysholm膝关节评分方面均较治疗前有改善(P<0.05)。治疗组各项指标的改善效果明显优于对照组(P<0.05)。对照组临床治疗总有效率达46.34%,治疗组总有效率达95.45%,治疗组的总有效率显著高于对照组,差异有统计学意义(P<0.05)。结论:ESWT联合传统治疗能明显缓解膝内侧副韧带陈旧性损伤患者膝关节疼痛,改善膝关节功能,疗效优于单纯传统治疗。