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In Jun Koh - One of the best experts on this subject based on the ideXlab platform.

  • Medial meniscal ramp lesion repair through anterior portals using a Medial Collateral Ligament pie crusting technique
    Arthroscopy techniques, 2021
    Co-Authors: Keun Young Choi, In Jun Koh, Man Soo Kim
    Abstract:

    Abstract Ramp injury, that is, injury to the peripheral attachment of the posterior horn of the Medial meniscus, often requires additional surgery during anterior cruciate Ligament (ACL) reconstruction. Diagnosis and treatment of ramp lesions are important because unrepaired ramp lesions could cause risk to the reconstructed ACL because of anteroposterior and external rotation laxity, whereas acute rupture or chronic deficiency of the ACL could also cause ramp lesions because of instability. Ramp lesions are difficult to diagnose and treat from the anterior compartment during arthroscopy. Typically, this repair requires technically demanding skills and is performed from the posterior portal using a suture hook under visualization with the arthroscope through the intercondylar notch. Inexperienced surgeons often struggle with using the posterior portal and the suture hook. Our all-inside repair technique using the FasT-Fix system (Smith & Nephew, Andover, MA) under direct visualization from the anterior compartment accompanied by a Medial Collateral Ligament pie-crusting technique facilitates repair of ramp lesions without causing Medial instability.

  • Superficial and Deep Medial Collateral Ligament Reconstruction for Chronic Medial Instability of the Knee.
    Arthroscopy techniques, 2019
    Co-Authors: Man Soo Kim, In Jun Koh
    Abstract:

    Abstract There are several surgical techniques for Medial Collateral Ligament reconstruction, including anatomic or nonanatomic Medial knee reconstruction. Although the Medial Collateral Ligament consists of the superficial Medial Collateral Ligament (sMCL) and deep Medial Collateral Ligament (dMCL), surgical procedures have only been described for reconstruction of the sMCL alone or reconstruction of the sMCL and posterior oblique Ligament. The dMCL assists the knee in rotational stability, primarily in extension, moving into early flexion. We describe sMCL and dMCL reconstruction with semitendinosus and gracilis autografts using adjustable-length loop suspensory fixation devices for tibial fixation. By use of our technique, it is possible to provide good stability and satisfactory results for Medial instability of the knee.

  • the pie crusting technique using a blade knife for Medial Collateral Ligament release is unreliable in varus total knee arthroplasty
    Knee Surgery Sports Traumatology Arthroscopy, 2016
    Co-Authors: Daisoon Kwak, In Jun Koh, Tae Kyun Kim, Han Suk Cho
    Abstract:

    Purpose Despite the documented clinical efficacy of the pie-crusting technique for Medial Collateral Ligament (MCL) release in varus total knee arthroplasty, its quantitative effects on Medial gaps and safety remain unclear. This study was undertaken to determine the efficacy (quantitative effect and consistency of the number of punctures) and the safety (frequency of early over-release) of the pie-crusting technique for MCL release.

Robert F. Laprade - One of the best experts on this subject based on the ideXlab platform.

  • superficial Medial Collateral Ligament reattachment during high tibial osteotomy regulate tension preserve stability
    Arthroscopy techniques, 2019
    Co-Authors: Konrad Malinowski, Robert F. Laprade, Adrian Góralczyk, Aleksandra Sibilska, Krzysztof Hermanowicz
    Abstract:

    High tibial osteotomy (HTO) is a commonly performed surgical procedure. Although it is well-known that the superficial Medial Collateral Ligament (sMCL) should be released during HTO, there is still no agreement on performing its reattachment. Considering the function of the sMCL, after its release during HTO, increased Medial joint instability may be expected. We present a technique for sMCL reattachment that prevents Medial gapping development and maintains nearly native pressure on the Medial compartment of the knee joint by matching the tension on the sMCL to the size of the osteotomy gap. This technique is suitable for any correction angle.

  • Medial Collateral Ligament injuries identified at the national football league scouting combine assessment of epidemiological characteristics imaging findings and initial career performance
    Orthopaedic Journal of Sports Medicine, 2018
    Co-Authors: Catherine Logan, Robert F. Laprade, Colin P Murphy, Anthony Sanchez, Grant J Dornan, James M Whalen, Mark D Price, James P Bradley, Matthew T Provencher
    Abstract:

    Background:The Medial Collateral Ligament (MCL) is one of the most commonly injured structures in the knee, especially in young athletes. The impact of MCL injury on National Football League (NFL) ...

  • post operative rehabilitation of grade iii Medial Collateral Ligament injuries evidence based rehabilitation and return to play
    The International journal of sports physical therapy, 2016
    Co-Authors: Catherine Logan, Luke Obrien, Robert F. Laprade
    Abstract:

    The Medial Collateral Ligament is the most commonly injured Ligament of the knee, with injury generally sustained in the athletic population as a result of valgus contact with or without tibial external rotation. The capacity of the Medial Collateral Ligament to heal has been demonstrated in both laboratory and clinical studies; however, complete ruptures heal less consistently and may result in persistent instability. When operative intervention is deemed necessary, anatomical Medial knee reconstruction is recommended. Post-operative rehabilitation focuses on early motion and the return of normal neuromuscular firing patterns with progression based on attainment of specific phase criteria and goals. The purpose of this clinical commentary is to discuss the determinants of phase progression and the importance of objectively assessing readiness for advancement that is consistent with post-operative healing. Additional tests and validated measures to assess readiness for sport are also presented. Level of Evidence 5

  • superficial Medial Collateral Ligament anatomic augmented repair versus anatomic reconstruction an in vitro biomechanical analysis
    American Journal of Sports Medicine, 2013
    Co-Authors: Coen A. Wijdicks, Lars Engebretsen, Martin Lind, Max P Michalski, Matthew T Rasmussen, Mary T Goldsmith, Nicholas I Kennedy, Robert F. Laprade
    Abstract:

    Background:When surgical intervention is required for a grade 3 superficial Medial Collateral Ligament (sMCL) tear, there is no consensus on the optimal surgical treatment. Anatomic augmented repairs and anatomic reconstructions for treatment of grade 3 sMCL tears have not been biomechanically validated or compared.Hypothesis:Anatomic sMCL augmented repairs and anatomic sMCL reconstruction techniques will reproduce equivalent knee kinematics when compared with the intact state, while creating significant improvements in translational and rotational laxity compared with the sMCL sectioned state.Study Design:Controlled laboratory study.Methods:Eighteen match-paired, fresh-frozen cadaveric knees (average age, 52.6 years; range, 40-59 years) were each used to test laxity of an intact sMCL, a deficient sMCL, and either an anatomic augmented repair or an anatomic reconstruction. Knees were biomechanically tested in a 6 degrees of freedom robotic system, which included valgus rotation, internal and external rota...

  • Injuries to the Medial Collateral Ligament and Associated Medial Structures of the Knee
    The Journal of bone and joint surgery. American volume, 2010
    Co-Authors: Coen A. Wijdicks, Chad J Griffith, Steinar Johansen, Lars Engebretsen, Robert F. Laprade
    Abstract:

    *The superficial Medial Collateral Ligament and other Medial knee stabilizers-i.e., the deep Medial Collateral Ligament and the posterior oblique Ligament-are the most commonly injured Ligamentous structures of the knee. *The main structures of the Medial aspect of the knee are the proximal and distal divisions of the superficial Medial Collateral Ligament, the meniscofemoral and meniscotibial divisions of the deep Medial Collateral Ligament, and the posterior oblique Ligament. *Physical examination is the initial method of choice for the diagnosis of Medial knee injuries through the application of a valgus load both at full knee extension and between 20 degrees and 30 degrees of knee flexion. *Because nonoperative treatment has a favorable outcome, there is a consensus that it should be the first step in the management of acute isolated grade-III injuries of the Medial Collateral Ligament or such injuries combined with an anterior cruciate Ligament tear. *If operative treatment is required, an anatomic repair or reconstruction is recommended.

Lars Engebretsen - One of the best experts on this subject based on the ideXlab platform.

  • superficial Medial Collateral Ligament anatomic augmented repair versus anatomic reconstruction an in vitro biomechanical analysis
    American Journal of Sports Medicine, 2013
    Co-Authors: Coen A. Wijdicks, Lars Engebretsen, Martin Lind, Max P Michalski, Matthew T Rasmussen, Mary T Goldsmith, Nicholas I Kennedy, Robert F. Laprade
    Abstract:

    Background:When surgical intervention is required for a grade 3 superficial Medial Collateral Ligament (sMCL) tear, there is no consensus on the optimal surgical treatment. Anatomic augmented repairs and anatomic reconstructions for treatment of grade 3 sMCL tears have not been biomechanically validated or compared.Hypothesis:Anatomic sMCL augmented repairs and anatomic sMCL reconstruction techniques will reproduce equivalent knee kinematics when compared with the intact state, while creating significant improvements in translational and rotational laxity compared with the sMCL sectioned state.Study Design:Controlled laboratory study.Methods:Eighteen match-paired, fresh-frozen cadaveric knees (average age, 52.6 years; range, 40-59 years) were each used to test laxity of an intact sMCL, a deficient sMCL, and either an anatomic augmented repair or an anatomic reconstruction. Knees were biomechanically tested in a 6 degrees of freedom robotic system, which included valgus rotation, internal and external rota...

  • Injuries to the Medial Collateral Ligament and Associated Medial Structures of the Knee
    The Journal of bone and joint surgery. American volume, 2010
    Co-Authors: Coen A. Wijdicks, Chad J Griffith, Steinar Johansen, Lars Engebretsen, Robert F. Laprade
    Abstract:

    *The superficial Medial Collateral Ligament and other Medial knee stabilizers-i.e., the deep Medial Collateral Ligament and the posterior oblique Ligament-are the most commonly injured Ligamentous structures of the knee. *The main structures of the Medial aspect of the knee are the proximal and distal divisions of the superficial Medial Collateral Ligament, the meniscofemoral and meniscotibial divisions of the deep Medial Collateral Ligament, and the posterior oblique Ligament. *Physical examination is the initial method of choice for the diagnosis of Medial knee injuries through the application of a valgus load both at full knee extension and between 20 degrees and 30 degrees of knee flexion. *Because nonoperative treatment has a favorable outcome, there is a consensus that it should be the first step in the management of acute isolated grade-III injuries of the Medial Collateral Ligament or such injuries combined with an anterior cruciate Ligament tear. *If operative treatment is required, an anatomic repair or reconstruction is recommended.

  • Medial knee injury part 2 load sharing between the posterior oblique Ligament and superficial Medial Collateral Ligament
    American Journal of Sports Medicine, 2009
    Co-Authors: Coen A. Wijdicks, Robert F. Laprade, Chad J Griffith, Steinar Johansen, Stanislav I Spiridonov, Bryan M Armitage, Lars Engebretsen
    Abstract:

    BackgroundThere is limited information regarding directly measured load responses of the posterior oblique and superficial Medial Collateral Ligaments in isolated and multiple Medial knee Ligament injury states.HypothesesTensile load responses from both the superficial Medial Collateral Ligament and the posterior oblique Ligament would be measurable and reproducible, and the native load-sharing relationships between these Ligaments would be altered after sectioning of Medial knee structures.Study DesignDescriptive laboratory study.MethodsTwenty-four nonpaired, fresh-frozen adult cadaveric knees were distributed into 3 sequential sectioning sequences. Buckle transducers were applied to the posterior oblique Ligament and the proximal and distal divisions of the superficial Medial Collateral Ligament; 10 N·m valgus moments and 5 N·m internal and external rotation torques were applied at 0°, 20°, 30°, 60°, and 90° of knee flexion.ResultsWith an applied valgus and external rotation moment, there was a signific...

  • part 2 load sharing between the posterior oblique Ligament and superficial Medial Collateral Ligament
    2009
    Co-Authors: Coen A. Wijdicks, Robert F. Laprade, Chad J Griffith, Steinar Johansen, Stanislav I Spiridonov, Bryan M Armitage, Lars Engebretsen
    Abstract:

    Results: With an applied valgus and external rotation moment, there was a significant load increase on the posterior oblique Ligament compared with the intact state after sectioning all other Medial knee structures. With an applied external rotation torque, there was a significant load decrease on the proximal division of the superficial Medial Collateral Ligament from the intact state after sectioning all other Medial knee structures. With an applied external rotation torque, the distal division of the superficial Medial Collateral Ligament experienced a significant load increase from the intact state after sectioning the posterior oblique Ligament and the meniscofemoral division of the deep Medial Collateral Ligament. Conclusion: This study found alterations in the native load-sharing relationships of the Medial knee structures after injury. Sectioning both the primary and secondary restraints to valgus and internal/external rotation of the knee alters the intricate load- sharing relationships that exist between the Medial knee structures. Clinical Significance: In cases in which surgical repair or reconstruction is indicated, consideration should be placed on repair- ing or reconstructing all injured Medial knee structures to restore the native load-sharing relationships among these Medial knee structures.

  • force measurements on the posterior oblique Ligament and superficial Medial Collateral Ligament proximal and distal divisions to applied loads
    American Journal of Sports Medicine, 2009
    Co-Authors: Chad J Griffith, Robert F. Laprade, Coen A. Wijdicks, Steinar Johansen, Bryan M Armitage, Lars Engebretsen
    Abstract:

    BackgroundThere is limited information regarding load responses of the posterior oblique and superficial Medial Collateral Ligaments to applied loads.HypothesesThe degree of knee flexion affects loads experienced by the posterior oblique Ligament and both divisions of the superficial Medial Collateral Ligament. The posterior oblique Ligament provides significant resistance to valgus and internal rotation forces near knee extension. Different load responses are experienced by proximal and distal divisions of the superficial Medial Collateral Ligament.Study DesignDescriptive laboratory study.MethodsTwenty-four nonpaired, fresh-frozen cadaveric knees were tested. Buckle transducers were applied to the proximal and distal divisions of the superficial Medial Collateral and posterior oblique Ligaments. Applied loads at 0°, 20°, 30°, 60°, and 90° of knee flexion consisted of 10 N.m valgus loads, 5 N .m internal and external rotation torques, and 88 N anterior and posterior drawer loads.ResultsExternal rotation t...

Coen A. Wijdicks - One of the best experts on this subject based on the ideXlab platform.

  • superficial Medial Collateral Ligament anatomic augmented repair versus anatomic reconstruction an in vitro biomechanical analysis
    American Journal of Sports Medicine, 2013
    Co-Authors: Coen A. Wijdicks, Lars Engebretsen, Martin Lind, Max P Michalski, Matthew T Rasmussen, Mary T Goldsmith, Nicholas I Kennedy, Robert F. Laprade
    Abstract:

    Background:When surgical intervention is required for a grade 3 superficial Medial Collateral Ligament (sMCL) tear, there is no consensus on the optimal surgical treatment. Anatomic augmented repairs and anatomic reconstructions for treatment of grade 3 sMCL tears have not been biomechanically validated or compared.Hypothesis:Anatomic sMCL augmented repairs and anatomic sMCL reconstruction techniques will reproduce equivalent knee kinematics when compared with the intact state, while creating significant improvements in translational and rotational laxity compared with the sMCL sectioned state.Study Design:Controlled laboratory study.Methods:Eighteen match-paired, fresh-frozen cadaveric knees (average age, 52.6 years; range, 40-59 years) were each used to test laxity of an intact sMCL, a deficient sMCL, and either an anatomic augmented repair or an anatomic reconstruction. Knees were biomechanically tested in a 6 degrees of freedom robotic system, which included valgus rotation, internal and external rota...

  • Injuries to the Medial Collateral Ligament and Associated Medial Structures of the Knee
    The Journal of bone and joint surgery. American volume, 2010
    Co-Authors: Coen A. Wijdicks, Chad J Griffith, Steinar Johansen, Lars Engebretsen, Robert F. Laprade
    Abstract:

    *The superficial Medial Collateral Ligament and other Medial knee stabilizers-i.e., the deep Medial Collateral Ligament and the posterior oblique Ligament-are the most commonly injured Ligamentous structures of the knee. *The main structures of the Medial aspect of the knee are the proximal and distal divisions of the superficial Medial Collateral Ligament, the meniscofemoral and meniscotibial divisions of the deep Medial Collateral Ligament, and the posterior oblique Ligament. *Physical examination is the initial method of choice for the diagnosis of Medial knee injuries through the application of a valgus load both at full knee extension and between 20 degrees and 30 degrees of knee flexion. *Because nonoperative treatment has a favorable outcome, there is a consensus that it should be the first step in the management of acute isolated grade-III injuries of the Medial Collateral Ligament or such injuries combined with an anterior cruciate Ligament tear. *If operative treatment is required, an anatomic repair or reconstruction is recommended.

  • Medial knee injury part 2 load sharing between the posterior oblique Ligament and superficial Medial Collateral Ligament
    American Journal of Sports Medicine, 2009
    Co-Authors: Coen A. Wijdicks, Robert F. Laprade, Chad J Griffith, Steinar Johansen, Stanislav I Spiridonov, Bryan M Armitage, Lars Engebretsen
    Abstract:

    BackgroundThere is limited information regarding directly measured load responses of the posterior oblique and superficial Medial Collateral Ligaments in isolated and multiple Medial knee Ligament injury states.HypothesesTensile load responses from both the superficial Medial Collateral Ligament and the posterior oblique Ligament would be measurable and reproducible, and the native load-sharing relationships between these Ligaments would be altered after sectioning of Medial knee structures.Study DesignDescriptive laboratory study.MethodsTwenty-four nonpaired, fresh-frozen adult cadaveric knees were distributed into 3 sequential sectioning sequences. Buckle transducers were applied to the posterior oblique Ligament and the proximal and distal divisions of the superficial Medial Collateral Ligament; 10 N·m valgus moments and 5 N·m internal and external rotation torques were applied at 0°, 20°, 30°, 60°, and 90° of knee flexion.ResultsWith an applied valgus and external rotation moment, there was a signific...

  • part 2 load sharing between the posterior oblique Ligament and superficial Medial Collateral Ligament
    2009
    Co-Authors: Coen A. Wijdicks, Robert F. Laprade, Chad J Griffith, Steinar Johansen, Stanislav I Spiridonov, Bryan M Armitage, Lars Engebretsen
    Abstract:

    Results: With an applied valgus and external rotation moment, there was a significant load increase on the posterior oblique Ligament compared with the intact state after sectioning all other Medial knee structures. With an applied external rotation torque, there was a significant load decrease on the proximal division of the superficial Medial Collateral Ligament from the intact state after sectioning all other Medial knee structures. With an applied external rotation torque, the distal division of the superficial Medial Collateral Ligament experienced a significant load increase from the intact state after sectioning the posterior oblique Ligament and the meniscofemoral division of the deep Medial Collateral Ligament. Conclusion: This study found alterations in the native load-sharing relationships of the Medial knee structures after injury. Sectioning both the primary and secondary restraints to valgus and internal/external rotation of the knee alters the intricate load- sharing relationships that exist between the Medial knee structures. Clinical Significance: In cases in which surgical repair or reconstruction is indicated, consideration should be placed on repair- ing or reconstructing all injured Medial knee structures to restore the native load-sharing relationships among these Medial knee structures.

  • force measurements on the posterior oblique Ligament and superficial Medial Collateral Ligament proximal and distal divisions to applied loads
    American Journal of Sports Medicine, 2009
    Co-Authors: Chad J Griffith, Robert F. Laprade, Coen A. Wijdicks, Steinar Johansen, Bryan M Armitage, Lars Engebretsen
    Abstract:

    BackgroundThere is limited information regarding load responses of the posterior oblique and superficial Medial Collateral Ligaments to applied loads.HypothesesThe degree of knee flexion affects loads experienced by the posterior oblique Ligament and both divisions of the superficial Medial Collateral Ligament. The posterior oblique Ligament provides significant resistance to valgus and internal rotation forces near knee extension. Different load responses are experienced by proximal and distal divisions of the superficial Medial Collateral Ligament.Study DesignDescriptive laboratory study.MethodsTwenty-four nonpaired, fresh-frozen cadaveric knees were tested. Buckle transducers were applied to the proximal and distal divisions of the superficial Medial Collateral and posterior oblique Ligaments. Applied loads at 0°, 20°, 30°, 60°, and 90° of knee flexion consisted of 10 N.m valgus loads, 5 N .m internal and external rotation torques, and 88 N anterior and posterior drawer loads.ResultsExternal rotation t...

Graham J W King - One of the best experts on this subject based on the ideXlab platform.

  • in vitro quantification of Medial Collateral Ligament tension in the elbow
    Journal of Applied Biomechanics, 2017
    Co-Authors: Louis M Ferreira, Graham J W King, James A. Johnson
    Abstract:

    The anterior bundle of the Medial Collateral Ligament (AMCL) of the elbow is commonly injured in patients with elbow dislocations and in throwing athletes. This in-vitro study quantified tension in the native AMCL throughout elbow flexion for different arm positions. We conducted passive and simulated active elbow flexion in seven fresh-frozen cadaveric upper extremities using an established motion simulator. Motions were performed in the valgus and vertical positions from 20-120° while measuring AMCL tension using a custom transducer. Average AMCL tension was higher in the valgus compared to vertical position for both active (p = 0.03) and passive (p = 0.01) motion. Peak AMCL tension was higher in the valgus position for active (p = 0.02) and passive (p = 0.01) motion. There was no significant difference in AMCL tension between active and passive motion in the valgus (p = 0.15) or vertical (p = 0.39) positions. In the valgus position, tension increased with elbow flexion from 20-70° for both active (p = 0.04) and passive (p = 0.02) motion, but not from 70-120°. This in-vitro study demonstrated that AMCL tension increases with elbow flexion, and is greater in the valgus position relative to the vertical position. This information has important implications to the desired target strength of repair and reconstruction techniques.

  • the effect of Medial Collateral Ligament repair tension on elbow joint kinematics and stability
    Journal of Hand Surgery (European Volume), 2007
    Co-Authors: J E Pichora, James A. Johnson, Gillian S Fraser, L F Ferreira, Jamie Brownhill, Graham J W King
    Abstract:

    Purpose Medial Collateral Ligament (MCL) repair is commonly performed for the management of acute or subacute instability after elbow dislocations and fracture-dislocations. The effectiveness of transosseous repair of the MCL, as is typically performed clinically, in restoring the normal kinematics and stability of the elbow is of interest as is the effect of MCL tensioning on the initial stability of the elbow. The purpose of this study was to determine whether suture repair of the MCL is able to restore the normal kinematics and stability of the elbow and to determine the optimal initial MCL repair tension. Methods Six cadaveric upper extremities were mounted in an upper limb joint simulator. Simulated active and passive elbow flexion was generated while the kinematics were measured with the arm in the dependent and the valgus gravity-loaded orientations. After testing the intact elbow, the MCL was released at its humeral attachment and repaired using a transosseous suture technique at three different repair tensions: 20, 40, and 60 N. Results Medial Collateral Ligament repair using a transosseous suture technique restored the kinematics and stability of the MCL-deficient elbow. Motion pathways were affected by the magnitude of initial MCL tension. For all arm orientations and forearm positions, the 20-N and 40-N repairs were not statistically different from each other or from the intact MCL. The 60-N repairs, however, were often statistically different than the other groups, suggesting an overtightening that tended to pull the ulna into a varus position—especially in the midrange of flexion. Conclusions These data suggest that MCL repair using transosseous sutures provide adequate joint stability to permit early motion. There is a broad range of acceptable tensions for MCL repair, which is a favorable, clinically relevant finding. Clinical studies are needed to validate these in vitro results.

  • efficacy of interference screw and double docking methods using palmaris longus and graftjacket for Medial Collateral Ligament reconstruction of the elbow
    Journal of Shoulder and Elbow Surgery, 2007
    Co-Authors: Keizo Furukawa, J E Pichora, James A. Johnson, Kenneth J. Faber, Scott P. Steinmann, Graham J W King
    Abstract:

    Single-strand elbow Medial Collateral Ligament reconstruction strength was evaluated by use of double-docking and interference screw methods with either a palmaris longus tendon or GraftJacket as the reconstruction material. Thirteen upper extremities were mounted in 90° of valgus orientation and subjected to cyclic valgus loading that increased progressively until failure occurred. The double-docking reconstructions outperformed the interference screw reconstructions (P .05). The favorable initial strength of the GraftJacket make it a potentially viable alternative to the use of autogenous palmaris longus tendons; however, further studies are required to evaluate graft strength during healing. The clinical use of the double-docking technique of single-strand Medial Collateral Ligament reconstruction should be considered because of its simplicity and initial strength.

  • a biomechanical comparison of four reconstruction techniques for the Medial Collateral Ligament deficient elbow
    Journal of Shoulder and Elbow Surgery, 2005
    Co-Authors: April D Armstrong, James A. Johnson, Kenneth J. Faber, Louis M Ferreira, Cynthia E Dunning, Graham J W King
    Abstract:

    The initial strength of the intact Medial Collateral Ligament (MCL) of the elbow and the strength of 4 reconstruction techniques were compared. Twenty cadaveric upper extremities were mounted in a custom jig with the elbow at 90°, and a pneumatic cyclic valgus loading protocol was used. The mean peak load to failure was 142.5 ± 39.4 N for the intact Ligaments and 53.0 ± 9.5 N for the docking reconstructions, 52.5 ± 10.4 N for the EndoButton reconstructions, 41.0 ± 16.0 N for the interference screw reconstructions, and 33.3 ± 7.1 N for the figure-eight reconstructions. The peak load to failure of the MCL reconstructions was inferior compared with the intact Ligament (P .05, β = .14). Both of these reconstruction methods were stronger than the interference screw or figure-eight technique (P