Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2015

01-10-2015 | Knee

Anteromedial rotatory laxity

Authors: Lars Engebretsen, Martin Lind

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2015

Login to get access

Abstract

This paper describes anteromedial rotatory laxity of the knee joint. Combined instability of the superficial MCL and the structures of the posteromedial corner is the pathological background anteromedial rotatory laxity. Anteromedial rotatory instability is clinically characterized by anteromedial tibial plateau subluxation anterior to the corresponding femoral condyle. The anatomical and biomechanical background for anteromedial laxity is presented and related to the clinical evaluation, and treatment decision strategies are mentioned. A review of the clinical studies that address surgical treatment of anteromedial rotatory instability including surgical techniques and clinical outcomes is presented.
Level of evidence V.
Literature
1.
go back to reference Borden PS, Kantaras AT, Caborn DN (2002) Medial collateral ligament reconstruction with allograft using a double-bundle technique. Arthroscopy 18(4):E19CrossRefPubMed Borden PS, Kantaras AT, Caborn DN (2002) Medial collateral ligament reconstruction with allograft using a double-bundle technique. Arthroscopy 18(4):E19CrossRefPubMed
2.
go back to reference Bosworth DM (1952) Transplantation of the semitendinosus for repair of laceration of medial collateral ligament of the knee. J Bone LaPrade Surg Am 34-A(1):196–202 Bosworth DM (1952) Transplantation of the semitendinosus for repair of laceration of medial collateral ligament of the knee. J Bone LaPrade Surg Am 34-A(1):196–202
3.
go back to reference Coobs BR, LaPrade RF, Griffith CJ, Nelson BJ (2007) Biomechanical analysis of an isolated fibular (lateral) collateral ligament reconstruction using an autogenous semitendinosus graft. Am J Sports Med 35(9):1521–1527CrossRefPubMed Coobs BR, LaPrade RF, Griffith CJ, Nelson BJ (2007) Biomechanical analysis of an isolated fibular (lateral) collateral ligament reconstruction using an autogenous semitendinosus graft. Am J Sports Med 35(9):1521–1527CrossRefPubMed
4.
go back to reference Coobs BR, Wijdicks CA, Armitage BM, Spiridonov SI, Westerhaus BD, Johansen S, Engebretsen L, LaPrade RF (2010) An in vitro analysis of an anatomical medial knee reconstruction. Am J Sports Med 38(2):339–347CrossRefPubMed Coobs BR, Wijdicks CA, Armitage BM, Spiridonov SI, Westerhaus BD, Johansen S, Engebretsen L, LaPrade RF (2010) An in vitro analysis of an anatomical medial knee reconstruction. Am J Sports Med 38(2):339–347CrossRefPubMed
5.
go back to reference Ellsasser JC, Reynolds FC, Omohundro JR (1974) The non-operative treatment of collateral ligament injuries of the knee in professional football players. An analysis of seventy-four injuries treated non-operatively and twenty-four injuries treated surgically. J Bone Joint Surg Am 56(6):1185–1190PubMed Ellsasser JC, Reynolds FC, Omohundro JR (1974) The non-operative treatment of collateral ligament injuries of the knee in professional football players. An analysis of seventy-four injuries treated non-operatively and twenty-four injuries treated surgically. J Bone Joint Surg Am 56(6):1185–1190PubMed
6.
go back to reference Giannotti BF, Fanelli GC, Barrett TA, Edson C (1996) The predictive value of intraoperative KT-1000 arthrometer measurements in single incision anterior cruciate ligament reconstruction. Arthroscopy 12(6):660–666CrossRefPubMed Giannotti BF, Fanelli GC, Barrett TA, Edson C (1996) The predictive value of intraoperative KT-1000 arthrometer measurements in single incision anterior cruciate ligament reconstruction. Arthroscopy 12(6):660–666CrossRefPubMed
7.
go back to reference Gorin S, Paul DD, Wilkinson EJ (2003) An anterior cruciate ligament and medial collateral ligament tear in a skeletally immature patient: a new technique to augment primary repair of the medial collateral ligament and an allograft reconstruction of the anterior cruciate ligament. Arthroscopy 19(10):E21–E26CrossRefPubMed Gorin S, Paul DD, Wilkinson EJ (2003) An anterior cruciate ligament and medial collateral ligament tear in a skeletally immature patient: a new technique to augment primary repair of the medial collateral ligament and an allograft reconstruction of the anterior cruciate ligament. Arthroscopy 19(10):E21–E26CrossRefPubMed
8.
go back to reference Grana WA, Gimple K (1981) Reconstruction of traumatic complete loss of the medial collateral ligament: a case report. Clin Orthop Relat Res 160:153–157PubMed Grana WA, Gimple K (1981) Reconstruction of traumatic complete loss of the medial collateral ligament: a case report. Clin Orthop Relat Res 160:153–157PubMed
9.
go back to reference Griffith CJ, LaPrade RF, Johansen S, Armitage B, Wijdicks C, Engebretsen L (2009) Medial knee injury: part 1, static function of the individual components of the main medial knee structures. Am J Sports Med 37(9):1762–1770CrossRefPubMed Griffith CJ, LaPrade RF, Johansen S, Armitage B, Wijdicks C, Engebretsen L (2009) Medial knee injury: part 1, static function of the individual components of the main medial knee structures. Am J Sports Med 37(9):1762–1770CrossRefPubMed
10.
go back to reference Griffith CJ, Wijdicks CA, LaPrade RF, Armitage BM, Johansen S, Engebretsen L (2009) Force measurements on the posterior oblique ligament and superficial medial collateral ligament proximal and distal divisions to applied loads. Am J Sports Med 37(1):140–148CrossRefPubMed Griffith CJ, Wijdicks CA, LaPrade RF, Armitage BM, Johansen S, Engebretsen L (2009) Force measurements on the posterior oblique ligament and superficial medial collateral ligament proximal and distal divisions to applied loads. Am J Sports Med 37(1):140–148CrossRefPubMed
11.
go back to reference Grood ES, Noyes FR, Butler DL, Suntay WJ (1981) Ligamentous and capsular restraints preventing straight medial and lateral laxity in intact human cadaver knees. J Bone Joint Surg Am 63(8):1257–1269PubMed Grood ES, Noyes FR, Butler DL, Suntay WJ (1981) Ligamentous and capsular restraints preventing straight medial and lateral laxity in intact human cadaver knees. J Bone Joint Surg Am 63(8):1257–1269PubMed
12.
go back to reference Hughston JC (1962) Acute knee injuries in athletes. Clin Orthop 23:114–133PubMed Hughston JC (1962) Acute knee injuries in athletes. Clin Orthop 23:114–133PubMed
13.
go back to reference Hughston JC (1994) The importance of the posterior oblique ligament in repairs of acute tears of the medial ligaments in knees with and without an associated rupture of the anterior cruciate ligament. Results of long-term follow-up. J Bone Joint Surg Am 76(9):1328–1344PubMed Hughston JC (1994) The importance of the posterior oblique ligament in repairs of acute tears of the medial ligaments in knees with and without an associated rupture of the anterior cruciate ligament. Results of long-term follow-up. J Bone Joint Surg Am 76(9):1328–1344PubMed
14.
go back to reference Hughston JC, Eilers AF (1973) The role of the posterior oblique ligament in repairs of acute medial (collateral) ligament tears of the knee. J Bone Joint Surg Am 55(5):923–940PubMed Hughston JC, Eilers AF (1973) The role of the posterior oblique ligament in repairs of acute medial (collateral) ligament tears of the knee. J Bone Joint Surg Am 55(5):923–940PubMed
15.
go back to reference Indelicato PA, Hermansdorfer J, Huegel M (1990) Nonoperative management of complete tears of the medial collateral ligament of the knee in intercollegiate football players. Clin Orthop Relat Res 256:174–177PubMed Indelicato PA, Hermansdorfer J, Huegel M (1990) Nonoperative management of complete tears of the medial collateral ligament of the knee in intercollegiate football players. Clin Orthop Relat Res 256:174–177PubMed
16.
go back to reference Jacobson KE, Chi FS (2006) Evaluation and treatment of medial collateral ligament and medial-sided injuries of the knee. Sports Med Arthrosc 14(2):58–66CrossRefPubMed Jacobson KE, Chi FS (2006) Evaluation and treatment of medial collateral ligament and medial-sided injuries of the knee. Sports Med Arthrosc 14(2):58–66CrossRefPubMed
17.
go back to reference Kannus P (1988) Long-term results of conservatively treated medial collateral ligament injuries of the knee joint. Clin Orthop Relat Res 226:103–112PubMed Kannus P (1988) Long-term results of conservatively treated medial collateral ligament injuries of the knee joint. Clin Orthop Relat Res 226:103–112PubMed
18.
go back to reference LaPrade RF, Bernhardson AS, Griffith CJ, Macalena JA, Wijdicks CA (2010) Correlation of valgus stress radiographs with medial knee ligament injuries: an in vitro biomechanical study. Am J Sports Med 38(2):330–338CrossRefPubMed LaPrade RF, Bernhardson AS, Griffith CJ, Macalena JA, Wijdicks CA (2010) Correlation of valgus stress radiographs with medial knee ligament injuries: an in vitro biomechanical study. Am J Sports Med 38(2):330–338CrossRefPubMed
19.
go back to reference LaPrade RF, Engebretsen AH, Ly TV, Johansen S, Wentorf FA, Engebretsen L (2007) The anatomy of the medial part of the knee. J Bone Joint Surg Am 89(9):2000–2010CrossRefPubMed LaPrade RF, Engebretsen AH, Ly TV, Johansen S, Wentorf FA, Engebretsen L (2007) The anatomy of the medial part of the knee. J Bone Joint Surg Am 89(9):2000–2010CrossRefPubMed
20.
go back to reference Laprade RF, Wijdicks CA (2012) The management of injuries to the medial side of the knee. J Orthop Sports Phys Ther 42(3):221–233CrossRefPubMed Laprade RF, Wijdicks CA (2012) The management of injuries to the medial side of the knee. J Orthop Sports Phys Ther 42(3):221–233CrossRefPubMed
21.
22.
go back to reference Lind M, Jakobsen BW, Lund B, Hansen MS, Abdallah O, Christiansen SE (2009) Anatomical reconstruction of the medial collateral ligament and posteromedial corner of the knee in patients with chronic medial collateral ligament instability. Am J Sports Med 37(6):1116–1122CrossRefPubMed Lind M, Jakobsen BW, Lund B, Hansen MS, Abdallah O, Christiansen SE (2009) Anatomical reconstruction of the medial collateral ligament and posteromedial corner of the knee in patients with chronic medial collateral ligament instability. Am J Sports Med 37(6):1116–1122CrossRefPubMed
23.
go back to reference Lubowitz JH, Bernardini BJ, Reid JB 3rd (2008) Current concepts review: comprehensive physical examination for instability of the knee. Am J Sports Med 36(3):577–594CrossRefPubMed Lubowitz JH, Bernardini BJ, Reid JB 3rd (2008) Current concepts review: comprehensive physical examination for instability of the knee. Am J Sports Med 36(3):577–594CrossRefPubMed
24.
go back to reference Marchant MH Jr, Tibor LM, Sekiya JK, Hardaker WT Jr, Garrett WE Jr, Taylor DC (2011) Management of medial-sided knee injuries, part 1: medial collateral ligament. Am J Sports Med 39(5):1102–1113CrossRefPubMed Marchant MH Jr, Tibor LM, Sekiya JK, Hardaker WT Jr, Garrett WE Jr, Taylor DC (2011) Management of medial-sided knee injuries, part 1: medial collateral ligament. Am J Sports Med 39(5):1102–1113CrossRefPubMed
25.
go back to reference Marx RG, Hetsroni I (2012) Surgical technique: medial collateral ligament reconstruction using Achilles allograft for combined knee ligament injury. Clin Orthop Relat Res 470(3):798–805PubMedCentralCrossRefPubMed Marx RG, Hetsroni I (2012) Surgical technique: medial collateral ligament reconstruction using Achilles allograft for combined knee ligament injury. Clin Orthop Relat Res 470(3):798–805PubMedCentralCrossRefPubMed
26.
go back to reference O’Donoghue DH (1973) Reconstruction for medial instability of the knee. J Bone Joint Surg Am 55(5):941–954PubMed O’Donoghue DH (1973) Reconstruction for medial instability of the knee. J Bone Joint Surg Am 55(5):941–954PubMed
27.
go back to reference Petersen W, Loerch S, Schanz S, Raschke M, Zantop T (2008) The role of the posterior oblique ligament in controlling posterior tibial translation in the posterior cruciate ligament-deficient knee. Am J Sports Med 36(3):495–501CrossRefPubMed Petersen W, Loerch S, Schanz S, Raschke M, Zantop T (2008) The role of the posterior oblique ligament in controlling posterior tibial translation in the posterior cruciate ligament-deficient knee. Am J Sports Med 36(3):495–501CrossRefPubMed
28.
go back to reference Robinson JR, Bull AM, Thomas RR, Amis AA (2006) The role of the medial collateral ligament and posteromedial capsule in controlling knee laxity. Am J Sports Med 34(11):1815–1823CrossRefPubMed Robinson JR, Bull AM, Thomas RR, Amis AA (2006) The role of the medial collateral ligament and posteromedial capsule in controlling knee laxity. Am J Sports Med 34(11):1815–1823CrossRefPubMed
29.
go back to reference Sims WF, Jacobson KE (2004) The posteromedial corner of the knee: medial-sided injury patterns revisited. Am J Sports Med 32(2):337–345CrossRefPubMed Sims WF, Jacobson KE (2004) The posteromedial corner of the knee: medial-sided injury patterns revisited. Am J Sports Med 32(2):337–345CrossRefPubMed
30.
go back to reference Slocum DB, Larson RL (1968) Pes anserinus transplantation. A surgical procedure for control of rotatory instability of the knee. J Bone Joint Surg Am 50(2):226–242PubMed Slocum DB, Larson RL (1968) Pes anserinus transplantation. A surgical procedure for control of rotatory instability of the knee. J Bone Joint Surg Am 50(2):226–242PubMed
31.
go back to reference Slocum DB, Larson RL (1968) Rotatory instability of the knee. Its pathogenesis and a clinical test to demonstrate its presence. J Bone Joint Surg Am 50(2):211–225PubMed Slocum DB, Larson RL (1968) Rotatory instability of the knee. Its pathogenesis and a clinical test to demonstrate its presence. J Bone Joint Surg Am 50(2):211–225PubMed
32.
go back to reference Slocum DB, Larson RL (2007) Rotatory instability of the knee: its pathogenesis and a clinical test to demonstrate its presence. 1968. Clin Orthop Relat Res 454:5–13 (discussion 13–14) CrossRefPubMed Slocum DB, Larson RL (2007) Rotatory instability of the knee: its pathogenesis and a clinical test to demonstrate its presence. 1968. Clin Orthop Relat Res 454:5–13 (discussion 13–14) CrossRefPubMed
33.
go back to reference Tibor LM, Marchant MH Jr, Taylor DC, Hardaker WT Jr, Garrett WE Jr, Sekiya JK (2011) Management of medial-sided knee injuries, part 2: posteromedial corner. Am J Sports Med 39(6):1332–1340CrossRefPubMed Tibor LM, Marchant MH Jr, Taylor DC, Hardaker WT Jr, Garrett WE Jr, Sekiya JK (2011) Management of medial-sided knee injuries, part 2: posteromedial corner. Am J Sports Med 39(6):1332–1340CrossRefPubMed
34.
go back to reference Torg JS, Conrad W, Kalen V (1976) Clinical diagnosis of anterior cruciate ligament instability in the athlete. Am J Sports Med 4(2):84–93CrossRefPubMed Torg JS, Conrad W, Kalen V (1976) Clinical diagnosis of anterior cruciate ligament instability in the athlete. Am J Sports Med 4(2):84–93CrossRefPubMed
35.
go back to reference Warren LA, Marshall JL, Girgis F (1974) The prime static stabilizer of the medical side of the knee. J Bone Joint Surg Am 56(4):665–674PubMed Warren LA, Marshall JL, Girgis F (1974) The prime static stabilizer of the medical side of the knee. J Bone Joint Surg Am 56(4):665–674PubMed
36.
go back to reference Wijdicks CA, Ewart DT, Nuckley DJ, Johansen S, Engebretsen L, LaPrade RF (2010) Structural properties of the primary medial knee ligaments. Am J Sports Med 38(8):1638–1646CrossRefPubMed Wijdicks CA, Ewart DT, Nuckley DJ, Johansen S, Engebretsen L, LaPrade RF (2010) Structural properties of the primary medial knee ligaments. Am J Sports Med 38(8):1638–1646CrossRefPubMed
37.
go back to reference Wijdicks CA, Griffith CJ, Johansen S, Engebretsen L, LaPrade RF (2010) Injuries to the medial collateral ligament and associated medial structures of the knee. J Bone Joint Surg Am 92(5):1266–1280CrossRefPubMed Wijdicks CA, Griffith CJ, Johansen S, Engebretsen L, LaPrade RF (2010) Injuries to the medial collateral ligament and associated medial structures of the knee. J Bone Joint Surg Am 92(5):1266–1280CrossRefPubMed
38.
go back to reference Yoshiya S, Kuroda R, Mizuno K, Yamamoto T, Kurosaka M (2005) Medial collateral ligament reconstruction using autogenous hamstring tendons: technique and results in initial cases. Am J Sports Med 33(9):1380–1385CrossRefPubMed Yoshiya S, Kuroda R, Mizuno K, Yamamoto T, Kurosaka M (2005) Medial collateral ligament reconstruction using autogenous hamstring tendons: technique and results in initial cases. Am J Sports Med 33(9):1380–1385CrossRefPubMed
Metadata
Title
Anteromedial rotatory laxity
Authors
Lars Engebretsen
Martin Lind
Publication date
01-10-2015
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3675-8

Other articles of this Issue 10/2015

Knee Surgery, Sports Traumatology, Arthroscopy 10/2015 Go to the issue