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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...

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Autores principales: Liu, Wenjun, Xiong, Hao, Chen, Shuai, Zhang, Jingwei, Wang, Wei, Qian, Yun, Fan, Cunyi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
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.
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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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