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Soft Tissue Surgery of the Knee
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Stephen Key, Jonathan Miles, Richard Carrington
With the recent interest in the description of an anterolateral ligament as a discrete structure, anterolateral ligament reconstructions are now performed by some surgeons in an attempt to address these issues. The authors’ preferred approach, however, is to perform a modified lateral extra-articular tenodesis, which has been shown to be biomechanically superior. This is achieved through a lateral incision by using a 1 cm wide central strip of iliotibial band, approximately 10 cm in length. It is detached proximally but left attached to Gerdy's tubercle distally. The proximal end is tunnelled deep to the LCL. It is secured to the lateral distal femur proximal and posterior to the lateral epicondyle with a ligament staple, with the knee held at 30° flexion and neutral rotation, and with light tension, approximately 20N. The remaining free proximal end is then folded back distally superficial to the LCL and sutured to itself. The defect in the iliotibial band is closed.
How weakness of the tensor fascia lata and gluteus maximus may contribute to ACL injury: A new theory
Published in Physiotherapy Theory and Practice, 2020
Michael T. Cibulka, Jack Bennett
Knee joint laxity after ACL injury has been described as “the passive response of a joint to an externally applied load” (Musahl, Hoshino, Becker, and Karlsson, 2012). This description of joint laxity should also include a dynamic response to control knee joint mobility. The TFL/Gmax muscles with their attachment to the ITB likely play an important role in providing rotatory dynamic restraint of the tibia, along with the biceps femoris muscles and the anterolateral ligament complex. We hope this paper will provoke new thoughts and research on the dynamic role muscle, specifically the TFL and the Gmax muscles, may play in restraining the ACL from injury or help in prevention. The development of intervention programs to strengthen the TFL and or Gmax could be an important part of a physical therapist ACL program.
The effect of rectus femoris muscle modelling technique on knee joint kinematics: a preliminary study
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2019
E. Elyasi, A. Perrier, Y. Payan
The bones were modeled as rigid bodies. All the constraining ligaments including the patellar ligament, the lateral and medial patellar retinaculum ligaments, the collateral and cruciate ligaments and the anterolateral ligament were modeled as 1 D linear spring elements having 150 N/mm stiffness (Woo et al. 1991). The hamstring muscle group was modelled as 1 D while conserving the muscles’ anatomical moment arms. The 3 D active muscles consist of an active part using the Blemker constitutive model (Blemker et al. 2005) and a passive part considered to be neo-Hookean hyperelastic (Luboz et al. 2018) Muscle fibers are distributed along the length of the muscle in the direction of the vector connecting the muscle insertion sites. The quadriceps tendon attached to the 3 D rectus Femoris muscle was modeled as multipoint springs being able to wrap around the femur bone (Figure 1).
Superior rotational stability and lower re-ruptures rate after combined anterolateral and anterior cruciate ligament reconstruction compared to isolated anterior cruciate ligament reconstruction: a 2-year prospective randomized clinical trial
Published in The Physician and Sportsmedicine, 2023
Ștefan Mogos, Dinu Antonescu, Ioan-Cristian Stoica, Riccardo D’Ambrosi
The anterolateral ligament (ALL) is an individualized ligamentous structure located in the anterolateral region of the knee. It originates in the femur, proximal, and posterior to the lateral epicondyle and inserts in the tibia, posterior to the center of Gerdy’s tubercle, and proximal to the anterior margin of the fibular head [12–14]. Despite the various publications regarding the anatomy and biomechanics of the anterolateral ligament, only a few clinical studies were published [8,15–21].