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The Journal of Bone and Joint Surgery, Vol 67, Issue 1 136-146, Copyright © 1985 by Journal of Bone and Joint Surgery, Inc
Effects of joint load on the stiffness and laxity of ligament-deficient knees. An in vitro study of the anterior cruciate and medial collateral ligaments
SC Shoemaker and KL Markolf
We measured the effects of serial section of the medial collateral ligament
and anterior cruciate ligament and of the anterior cruciate ligament and
medial collateral ligament on anterior-posterior force-versus-displacement
and tibial torque-versus-rotation response curves for seven fresh frozen
cadaver knees at zero and 20 degrees of flexion before and after
application of as much as 925 newtons of compressive load on the
tibiofemoral joint. Section of the anterior cruciate ligament always
increased anterior laxity in an unloaded specimen; joint load reduced this
increase by a greater amount at zero degrees than at 20 degrees of flexion.
Joint load was more effective in limiting anterior laxity in anterior
cruciate-deficient specimens at low levels of applied anterior force; at
higher levels of applied force, the effects of joint congruency were
overcome and ligament restraints came into play. Section of the medial
collateral ligament increased anterior laxity in an unloaded knee only for
specimens in which the anterior cruciate ligament had been previously
sectioned; joint load eliminated this increase at full extension but did
not do so at 20 degrees of flexion. The medial collateral ligament was the
more important of the two ligaments in controlling torsional laxity.
Secondary section of either ligament (the other ligament having been
sectioned first) produced a greater increase in laxity than did primary
section of that ligament in an intact knee. Increases in torsional laxity
due to primary section of either ligament were unaffected by the
application of joint load. Joint load reduced increases in laxity that were
due to secondary section of the medial collateral ligament.
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