HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) All Versions of this Article: 34/10/1623    most recent 0363546506288013v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Csintalan, R. P. Articles by Lee, T. Q. Search for Related Content PubMed PubMed Citation Articles by Csintalan, R. P. Articles by Lee, T. Q.

Biomechanical and Anatomical Effects of an External Rotational Torque Applied to the Knee

A Cadaveric Study

Rick P. Csintalan, MD^*, Amirhesam Ehsan, MD^,, Michelle H. McGarry, MS, Donald F. Fithian, MD and Thay Q. Lee, PhD^,,||

From the ^* Kaiser Permanente, Anaheim, California, Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System, University of California, Irvine, California; and Kaiser Permanente, San Diego, California

^|| Address correspondence to Thay Q. Lee, PhD, Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System (09/151), 5901 East 7th Street, Long Beach, CA 90822 (e-mail: qlee{at}med.va.gov; tqlee{at}uci.edu).

Background: External rotational torque is one of the mechanisms that may occur during a pivoting or twisting injury to the knee.

Hypothesis: Simulated external rotational injury by applying external rotational torque will increase knee laxity and cause soft tissue damage to the knee.

Study Design: Controlled laboratory study.

Methods: Six cadaveric knees and a custom testing system were used to produce external rotational torque of 30°, 45°, and 60° with the knee at 30° of flexion. Anterior-posterior, valgus-varus, and rotational knee laxity were quantified. After sequential rotational torque to 60°, the specimens were dissected to identify injured structures.

Results: External rotational torque of 45° and 60° significantly increased knee joint laxity in all directions (P < .05). Dissection showed that all posterior cruciate ligaments were intact; all medial collateral and anterior cruciate ligaments revealed either partial or complete tears. The lateral collateral ligaments were torn in all specimens. The popliteus tendon was attenuated in 1 specimen and was completely torn in 1 specimen. The popliteofibular ligament was torn in 3 specimens.

Conclusion: External rotational torque to 60° increased knee laxity, and dissection revealed a consistent pattern of injury to the medial and lateral collateral and anterior cruciate ligaments and posterolateral corner.

Clinical Relevance: Because isolated ligament injuries are rare, recognizing these combined ligamentous injuries early is essential for repair in the acute stage.

Key Words: posterolateral corner • external rotation • laxity • cadaveric study

This article has been cited by other articles:

				S. Fornalski, M. H. McGarry, R. P. Csintalan, D. C. Fithian, and T. Q. Lee Biomechanical and Anatomical Assessment After Knee Hyperextension Injury Am. J. Sports Med., January 1, 2008; 36(1): 80 - 84. [Abstract] [Full Text] [PDF]