The Journal of Bone and Joint Surgery, Vol 59, Issue 1 107-116, Copyright © 1977 by Journal of Bone and Joint Surgery, Inc
Surgical repositioning of the medial collateral ligament. An anatomical and mechanical analysis
DL Bartel, JL Marshall, RA Schieck and JB Wang
Analytical techniques using multiple-exposure roentgenograms were employed
to investigate surgical repositioning of either the femoral or the tibial
attachment of the medial collateral ligament. The motion of the femoral
attachment of the ligament with respect to the tibial attachment was used
to compute the changes in length of the borders of the ligament for normal
knees and for knees with repositioned attachments. The results support the
conclusion that when advancement of the medial collateral ligament is
utilized in the treatment of medial instability, optimization is
accomplished by distal and anterior advancement with the knee in 30 degrees
of flexion. Femoral displacement (proximal realignment) or tibial
displacement at knee-flexion angles greater than 45 degrees is not
recommended.