Anteromedial knee instability

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Anterior cruciate ligament (ACL) lesion is a frequent injury in sport activities, particularly in high-contact sports. ACL functional insufficiency causes an increased anterior tibial translation (straight or primary instability) and an increased internal tibial axial rotation. Single-bundle ACL reconstruction was indicated by the literature and by the largest number of orthopaedic surgeons as the gold standard for acute or chronic ACL lesions, which could be easily diagnosed through clinical examination and magnetic resonance imaging (MRI). Rotational instability of the knee consequent to an ACL lesion is a stimulating argument both from a biomechanical point of view and from a surgical one. Clinically, rotational instability is referred to as a bi-axial combined instability during cutting movements, mainly during fast changes of directions such as a football player performs in dribbling. Hugston [1] classically distinguished anterior rotational instability in: - Anteromedial rotational instability (AMRI) due to a lesion of the medial compartment, including posterior oblique ligament (POL) ruptures. AMRI is increased in associated ACL lesions; - Anterolateral rotational instability (ALRI) caused by a tear of the central third and the lateral capsular ligament. Also, ALRI is empowered by associated ACL lesions. ACL functional insufficiency has been indicated as the main cause of AMRI, most of all with the knee near to its complete extension; however, several biomechanical studies reported in the current literature have shown that the medial collateral ligament (MCL) plays an important role in anteromedial rotational stabilisation, mainly at 30? of flexion. An unrecognized MCL instability consequent to a grade 3 MCL lesion can be a predisposing factor for ACL reconstruction failure. In fact, chronic MCL deficiency has been noted to increase stress on an ACL graft, particularly during the critical interval of the neoligamentisation [2]. Moreover, other authors have demonstrated that associated ligamentous functional deficit either not discovered or underestimated in preoperative planning can represent the main causes of ACL reconstruction failure [3].

Original languageEnglish
Title of host publicationFootball Traumatology: Current Concepts: From Prevention to Treatment
PublisherSpringer Milan
Pages217-230
Number of pages14
ISBN (Print)8847004187, 9788847004184
DOIs
Publication statusPublished - 2006

Fingerprint

Anterior Cruciate Ligament
Knee
Collateral Ligaments
Anterior Cruciate Ligament Reconstruction
Athletic Injuries
Football
Tears
Ligaments
Causality
Sports
Rupture
Magnetic Resonance Imaging
Transplants

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Marcacci, M., & Zaffagnini, S. (2006). Anteromedial knee instability. In Football Traumatology: Current Concepts: From Prevention to Treatment (pp. 217-230). Springer Milan. https://doi.org/10.1007/88-470-0419-5_20

Anteromedial knee instability. / Marcacci, Maurilio; Zaffagnini, Stefano.

Football Traumatology: Current Concepts: From Prevention to Treatment. Springer Milan, 2006. p. 217-230.

Research output: Chapter in Book/Report/Conference proceedingChapter

Marcacci, M & Zaffagnini, S 2006, Anteromedial knee instability. in Football Traumatology: Current Concepts: From Prevention to Treatment. Springer Milan, pp. 217-230. https://doi.org/10.1007/88-470-0419-5_20
Marcacci M, Zaffagnini S. Anteromedial knee instability. In Football Traumatology: Current Concepts: From Prevention to Treatment. Springer Milan. 2006. p. 217-230 https://doi.org/10.1007/88-470-0419-5_20
Marcacci, Maurilio ; Zaffagnini, Stefano. / Anteromedial knee instability. Football Traumatology: Current Concepts: From Prevention to Treatment. Springer Milan, 2006. pp. 217-230
@inbook{829571c9992143f39cf57407e6fd5ff6,
title = "Anteromedial knee instability",
abstract = "Anterior cruciate ligament (ACL) lesion is a frequent injury in sport activities, particularly in high-contact sports. ACL functional insufficiency causes an increased anterior tibial translation (straight or primary instability) and an increased internal tibial axial rotation. Single-bundle ACL reconstruction was indicated by the literature and by the largest number of orthopaedic surgeons as the gold standard for acute or chronic ACL lesions, which could be easily diagnosed through clinical examination and magnetic resonance imaging (MRI). Rotational instability of the knee consequent to an ACL lesion is a stimulating argument both from a biomechanical point of view and from a surgical one. Clinically, rotational instability is referred to as a bi-axial combined instability during cutting movements, mainly during fast changes of directions such as a football player performs in dribbling. Hugston [1] classically distinguished anterior rotational instability in: - Anteromedial rotational instability (AMRI) due to a lesion of the medial compartment, including posterior oblique ligament (POL) ruptures. AMRI is increased in associated ACL lesions; - Anterolateral rotational instability (ALRI) caused by a tear of the central third and the lateral capsular ligament. Also, ALRI is empowered by associated ACL lesions. ACL functional insufficiency has been indicated as the main cause of AMRI, most of all with the knee near to its complete extension; however, several biomechanical studies reported in the current literature have shown that the medial collateral ligament (MCL) plays an important role in anteromedial rotational stabilisation, mainly at 30? of flexion. An unrecognized MCL instability consequent to a grade 3 MCL lesion can be a predisposing factor for ACL reconstruction failure. In fact, chronic MCL deficiency has been noted to increase stress on an ACL graft, particularly during the critical interval of the neoligamentisation [2]. Moreover, other authors have demonstrated that associated ligamentous functional deficit either not discovered or underestimated in preoperative planning can represent the main causes of ACL reconstruction failure [3].",
author = "Maurilio Marcacci and Stefano Zaffagnini",
year = "2006",
doi = "10.1007/88-470-0419-5_20",
language = "English",
isbn = "8847004187",
pages = "217--230",
booktitle = "Football Traumatology: Current Concepts: From Prevention to Treatment",
publisher = "Springer Milan",

}

TY - CHAP

T1 - Anteromedial knee instability

AU - Marcacci, Maurilio

AU - Zaffagnini, Stefano

PY - 2006

Y1 - 2006

N2 - Anterior cruciate ligament (ACL) lesion is a frequent injury in sport activities, particularly in high-contact sports. ACL functional insufficiency causes an increased anterior tibial translation (straight or primary instability) and an increased internal tibial axial rotation. Single-bundle ACL reconstruction was indicated by the literature and by the largest number of orthopaedic surgeons as the gold standard for acute or chronic ACL lesions, which could be easily diagnosed through clinical examination and magnetic resonance imaging (MRI). Rotational instability of the knee consequent to an ACL lesion is a stimulating argument both from a biomechanical point of view and from a surgical one. Clinically, rotational instability is referred to as a bi-axial combined instability during cutting movements, mainly during fast changes of directions such as a football player performs in dribbling. Hugston [1] classically distinguished anterior rotational instability in: - Anteromedial rotational instability (AMRI) due to a lesion of the medial compartment, including posterior oblique ligament (POL) ruptures. AMRI is increased in associated ACL lesions; - Anterolateral rotational instability (ALRI) caused by a tear of the central third and the lateral capsular ligament. Also, ALRI is empowered by associated ACL lesions. ACL functional insufficiency has been indicated as the main cause of AMRI, most of all with the knee near to its complete extension; however, several biomechanical studies reported in the current literature have shown that the medial collateral ligament (MCL) plays an important role in anteromedial rotational stabilisation, mainly at 30? of flexion. An unrecognized MCL instability consequent to a grade 3 MCL lesion can be a predisposing factor for ACL reconstruction failure. In fact, chronic MCL deficiency has been noted to increase stress on an ACL graft, particularly during the critical interval of the neoligamentisation [2]. Moreover, other authors have demonstrated that associated ligamentous functional deficit either not discovered or underestimated in preoperative planning can represent the main causes of ACL reconstruction failure [3].

AB - Anterior cruciate ligament (ACL) lesion is a frequent injury in sport activities, particularly in high-contact sports. ACL functional insufficiency causes an increased anterior tibial translation (straight or primary instability) and an increased internal tibial axial rotation. Single-bundle ACL reconstruction was indicated by the literature and by the largest number of orthopaedic surgeons as the gold standard for acute or chronic ACL lesions, which could be easily diagnosed through clinical examination and magnetic resonance imaging (MRI). Rotational instability of the knee consequent to an ACL lesion is a stimulating argument both from a biomechanical point of view and from a surgical one. Clinically, rotational instability is referred to as a bi-axial combined instability during cutting movements, mainly during fast changes of directions such as a football player performs in dribbling. Hugston [1] classically distinguished anterior rotational instability in: - Anteromedial rotational instability (AMRI) due to a lesion of the medial compartment, including posterior oblique ligament (POL) ruptures. AMRI is increased in associated ACL lesions; - Anterolateral rotational instability (ALRI) caused by a tear of the central third and the lateral capsular ligament. Also, ALRI is empowered by associated ACL lesions. ACL functional insufficiency has been indicated as the main cause of AMRI, most of all with the knee near to its complete extension; however, several biomechanical studies reported in the current literature have shown that the medial collateral ligament (MCL) plays an important role in anteromedial rotational stabilisation, mainly at 30? of flexion. An unrecognized MCL instability consequent to a grade 3 MCL lesion can be a predisposing factor for ACL reconstruction failure. In fact, chronic MCL deficiency has been noted to increase stress on an ACL graft, particularly during the critical interval of the neoligamentisation [2]. Moreover, other authors have demonstrated that associated ligamentous functional deficit either not discovered or underestimated in preoperative planning can represent the main causes of ACL reconstruction failure [3].

UR - http://www.scopus.com/inward/record.url?scp=84895307774&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84895307774&partnerID=8YFLogxK

U2 - 10.1007/88-470-0419-5_20

DO - 10.1007/88-470-0419-5_20

M3 - Chapter

AN - SCOPUS:84895307774

SN - 8847004187

SN - 9788847004184

SP - 217

EP - 230

BT - Football Traumatology: Current Concepts: From Prevention to Treatment

PB - Springer Milan

ER -