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Biomechanical Evaluation of a Low-Invasive Elbow Medial Collateral Ligament Reconstruction Technique With Fascia and Tendon Patches
Background: Injury to the medial collateral ligament (MCL) of the elbow has become increasingly common in sports, and the elbow is prone to contracture and ossification in trauma. Effective reconstruction of the MCL with reduction of irritation to the elbow has rarely been reported. This study intro...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980741/ https://www.ncbi.nlm.nih.gov/pubmed/35392401 http://dx.doi.org/10.3389/fbioe.2022.831545 |
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author | Liu, Wenjun Xiong, Hao Chen, Shuai Zhang, Jingwei Wang, Wei Qian, Yun Fan, Cunyi |
author_facet | Liu, Wenjun Xiong, Hao Chen, Shuai Zhang, Jingwei Wang, Wei Qian, Yun Fan, Cunyi |
author_sort | Liu, Wenjun |
collection | PubMed |
description | Background: Injury to the medial collateral ligament (MCL) of the elbow has become increasingly common in sports, and the elbow is prone to contracture and ossification in trauma. Effective reconstruction of the MCL with reduction of irritation to the elbow has rarely been reported. This study introduces a minimally invasive elbow MCL reconstruction technique and evaluates the valgus stability. Methods: Eight fresh-frozen elbow specimens underwent reconstruction of the anterior bundle of the MCL (AMCL) first with the flexor carpi ulnaris fascia patches, followed by reconstruction of the posterior bundle of the MCL (PMCL) with the triceps tendon patches. The valgus angles of each specimen were examined in three stages as follows: intact MCL, reconstruction of the AMCL alone, and reconstruction of the MCL (including AMCL and PMCL). Finally, specimens were loaded to failure, and failure modes were recorded. Results: AMCL reconstruction alone had similar valgus stability at all testing angles (p = 0.080, 30° flexion; p = 0.064, 60° flexion; p = 0.151, 90° flexion; p = 0.283, 120° flexion) compared with the intact MCL, as did MCL reconstruction (p = 0.951, 30° flexion; p = 0.739, 60° flexion; p = 0.841, 90° flexion; p = 0.538, 120° flexion). More importantly, a significant difference existed between the MCL reconstruction and the AMCL reconstruction alone at 30° flexion (p = 0.043) and 60° flexion (p = 0.013) but not at the 90° flexion (p = 0.369) and 120° flexion (p = 0.879). The mean maximum failure torque of MCL reconstruction was 24.02 Nm at 90° elbow flexion. Conclusion: Both AMCL reconstruction alone and MCL reconstruction provided valgus stability comparable with the native MCL, and importantly, MCL reconstruction provided more valgus stability than AMCL reconstruction alone at 30° flexion and 60° flexion of the elbow. Therefore, the new MCL reconstruction technique might be a useful guide for the treatment of elbow MCL injuries or deficiencies. |
format | Online Article Text |
id | pubmed-8980741 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-89807412022-04-06 Biomechanical Evaluation of a Low-Invasive Elbow Medial Collateral Ligament Reconstruction Technique With Fascia and Tendon Patches Liu, Wenjun Xiong, Hao Chen, Shuai Zhang, Jingwei Wang, Wei Qian, Yun Fan, Cunyi Front Bioeng Biotechnol Bioengineering and Biotechnology Background: Injury to the medial collateral ligament (MCL) of the elbow has become increasingly common in sports, and the elbow is prone to contracture and ossification in trauma. Effective reconstruction of the MCL with reduction of irritation to the elbow has rarely been reported. This study introduces a minimally invasive elbow MCL reconstruction technique and evaluates the valgus stability. Methods: Eight fresh-frozen elbow specimens underwent reconstruction of the anterior bundle of the MCL (AMCL) first with the flexor carpi ulnaris fascia patches, followed by reconstruction of the posterior bundle of the MCL (PMCL) with the triceps tendon patches. The valgus angles of each specimen were examined in three stages as follows: intact MCL, reconstruction of the AMCL alone, and reconstruction of the MCL (including AMCL and PMCL). Finally, specimens were loaded to failure, and failure modes were recorded. Results: AMCL reconstruction alone had similar valgus stability at all testing angles (p = 0.080, 30° flexion; p = 0.064, 60° flexion; p = 0.151, 90° flexion; p = 0.283, 120° flexion) compared with the intact MCL, as did MCL reconstruction (p = 0.951, 30° flexion; p = 0.739, 60° flexion; p = 0.841, 90° flexion; p = 0.538, 120° flexion). More importantly, a significant difference existed between the MCL reconstruction and the AMCL reconstruction alone at 30° flexion (p = 0.043) and 60° flexion (p = 0.013) but not at the 90° flexion (p = 0.369) and 120° flexion (p = 0.879). The mean maximum failure torque of MCL reconstruction was 24.02 Nm at 90° elbow flexion. Conclusion: Both AMCL reconstruction alone and MCL reconstruction provided valgus stability comparable with the native MCL, and importantly, MCL reconstruction provided more valgus stability than AMCL reconstruction alone at 30° flexion and 60° flexion of the elbow. Therefore, the new MCL reconstruction technique might be a useful guide for the treatment of elbow MCL injuries or deficiencies. Frontiers Media S.A. 2022-03-22 /pmc/articles/PMC8980741/ /pubmed/35392401 http://dx.doi.org/10.3389/fbioe.2022.831545 Text en Copyright © 2022 Liu, Xiong, Chen, Zhang, Wang, Qian and Fan. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Bioengineering and Biotechnology Liu, Wenjun Xiong, Hao Chen, Shuai Zhang, Jingwei Wang, Wei Qian, Yun Fan, Cunyi Biomechanical Evaluation of a Low-Invasive Elbow Medial Collateral Ligament Reconstruction Technique With Fascia and Tendon Patches |
title | Biomechanical Evaluation of a Low-Invasive Elbow Medial Collateral Ligament Reconstruction Technique With Fascia and Tendon Patches |
title_full | Biomechanical Evaluation of a Low-Invasive Elbow Medial Collateral Ligament Reconstruction Technique With Fascia and Tendon Patches |
title_fullStr | Biomechanical Evaluation of a Low-Invasive Elbow Medial Collateral Ligament Reconstruction Technique With Fascia and Tendon Patches |
title_full_unstemmed | Biomechanical Evaluation of a Low-Invasive Elbow Medial Collateral Ligament Reconstruction Technique With Fascia and Tendon Patches |
title_short | Biomechanical Evaluation of a Low-Invasive Elbow Medial Collateral Ligament Reconstruction Technique With Fascia and Tendon Patches |
title_sort | biomechanical evaluation of a low-invasive elbow medial collateral ligament reconstruction technique with fascia and tendon patches |
topic | Bioengineering and Biotechnology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980741/ https://www.ncbi.nlm.nih.gov/pubmed/35392401 http://dx.doi.org/10.3389/fbioe.2022.831545 |
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