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The Journal of Bone and Joint Surgery, Vol 66, Issue 6 930-936, Copyright © 1984 by Journal of Bone and Joint Surgery, Inc
Medical restrains to anterior-posterior motion of the knee
D Sullivan, IM Levy, S Sheskier, PA Torzilli and RF Warren
We investigated the motion of cadaver knees before and after section of the
medial structures and anterior cruciate ligament. The knees were tested
using a 5-degrees-of-freedom in vitro knee-testing apparatus that measured
anterior-posterior, medial-lateral, and axial displacement as well as
internal-external and valgus-varus rotation. The flexion angle could be
varied but was fixed for each individual test. A 125-newton
anterior-posterior force was applied perpendicular to the tibial shaft and
the resulting motion of the knee was measured. In five knees the anterior
cruciate ligament was cut first, followed by progressive cuts of the
structures on the medial side (superficial medial collateral ligament, deep
medial ligament, oblique fibers of the superficial medial ligament, and the
posteromedial part of the capsule). Conversely, in five knees the medial
structures were progressively cut first, followed by section of the
anterior cruciate ligament. Tests were performed after each cut. With an
intact anterior cruciate ligament, progressive cutting of the medial side
had no effect on anterior and posterior displacements. When section of the
medial structures followed cutting of the anterior cruciate ligament,
anterior displacement exceeded that seen after isolated section of the
anterior cruciate ligament. The anterior and posterior load-tests were
repeated with the tibia fixed in 5 degrees of internal and 5 degrees of
external rotation. Fixed external rotation had no effect on anterior and
posterior displacements. Fixed internal rotation significantly decreased
anterior displacement only when both the anterior cruciate ligament and the
medial structures were cut.(ABSTRACT TRUNCATED AT 250 WORDS)
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