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The Journal of Bone and Joint Surgery, Vol 63, Issue 6 954-960, Copyright © 1981 by Journal of Bone and Joint Surgery, Inc
The role of incompetence of the anterior cruciate and lateral ligaments in anterolateral and anteromedial instability. A biomechanical study of cadaver knees
JM Lipke, CJ Janecki, CL Nelson, P McLeod, C Thompson, J Thompson and DW Haynes
The anterolateral and anteromedial stability of seventeen fresh frozen
cadaver knees was studied in a test apparatus designed to simulate
physiological conditions. Statistically significant increases in internal
rotation occurred in seven knees when only the anterior cruciate ligament
was sectioned, and these increases were enhanced by subsequent sectioning
of the posterolateral complex and the lateral collateral ligament, singly
or in combination. On the other hand, sectioning of the posterolateral
complex and of the lateral collateral ligament, leaving the anterior
cruciate intact, did not produce significant increases in internal rotation
until the anterior cruciate ligament was sectioned in seven knees. When the
entire anterolateral capsule was sectioned as far posterior as the lateral
collateral ligament in three knees, no changes in internal or external
rotation occurred. Only when the posterolateral complex was sectioned was
there a significant increase in external rotation in any of the
ligament-sectioning sequences. Thus, it appears that for pathological
internal rotation of the tibia on the femur to occur, the anterior cruciate
ligament must be incompetent. Clinical Relevance: The test apparatus and
the results are useful in assessing which ligament structures contribute to
clinically noted rotational knee instabilities.
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