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Function and strain of the anterolateral ligament part I: biomechanical analysis

Overview of attention for article published in Knee Surgery, Sports Traumatology, Arthroscopy, March 2017
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Title
Function and strain of the anterolateral ligament part I: biomechanical analysis
Published in
Knee Surgery, Sports Traumatology, Arthroscopy, March 2017
DOI 10.1007/s00167-017-4472-3
Pubmed ID
Authors

Björn Holger Drews, Oliver Kessler, Wolfgang Franz, Lutz Dürselen, Maren Freutel

Abstract

Because reconstruction of the anterior cruciate ligament (ACL) in a double-bundle technique did not solve the problem of persistent rotatory laxity after surgery, new potential answers to this issue are of great interest. One of these is an extraarticular stabilization based on the rediscovery of the anterolateral ligament (ALL). Knowledge about its biomechanical function and benchmark data for an optimal reconstruction remain lacking. Therefore, the purpose of this study was to assess the function of the ALL under passive motion, anterior tibial translation and tibial rotational moments. Continuous passive motion (0°-120° flexion), ap-translation and static pivot shift tests were performed on eight cadaveric knees. The knees were measured in intact, ACL-resected (ACLres) and ACL + ALL-resected (ALLres) conditions. Ap-translation and static pivot shift under 134 N anterior shear load were determined at 0°, 30°, 60° and 90° flexion. Strain of the ALL was recorded in intact and ACLres conditions. During continuous passive motion under unloaded conditions, no significant difference in internal rotation between ACLres and ALLres was observed. With an additional internal tibial torque of 1-4 Nm, internal rotation increased significantly between 60° and 120° after resection of the ALL (p ≤ 0.05). Anterior tibial translation was significantly higher at 30° in ALLres (p = 0.01) and for a simulated pivot shift at 60° and 90° in ACLres (p ≤ 0.01). The ALL was not strained under unloaded passive motion. Adding different internal tibial torques led to strain starting at 60° flexion (1 N m internal torque) and 15° flexion (4 N m internal torque) in intact ligaments. In ACLres, significantly greater ALL strains under lower flexion angles were seen for each condition (p ≤ 0.05). This study demonstrated the ALL to be without function under passive motion and with no influence on tibial rotation. On application of extrinsic loads, the ALL had a low but significant stabilizing effect against anterior tibial shear load at low flexion angles. For this reason, it can be concluded that the ALL is supporting the ACL against internal tibial loads to a minor degree. A relationship between the ALL and the pivot shift cannot be concluded. With these results ALL-reconstruction cannot be recommended at the moment without further biomechanical investigations.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 68 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Sweden 1 1%
Unknown 67 99%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 10 15%
Researcher 9 13%
Student > Master 8 12%
Student > Bachelor 8 12%
Student > Doctoral Student 4 6%
Other 10 15%
Unknown 19 28%
Readers by discipline Count As %
Medicine and Dentistry 22 32%
Engineering 7 10%
Nursing and Health Professions 5 7%
Sports and Recreations 5 7%
Veterinary Science and Veterinary Medicine 2 3%
Other 3 4%
Unknown 24 35%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 April 2017.
All research outputs
#12,972,913
of 22,963,381 outputs
Outputs from Knee Surgery, Sports Traumatology, Arthroscopy
#1,339
of 2,669 outputs
Outputs of similar age
#151,437
of 310,508 outputs
Outputs of similar age from Knee Surgery, Sports Traumatology, Arthroscopy
#28
of 53 outputs
Altmetric has tracked 22,963,381 research outputs across all sources so far. This one is in the 43rd percentile – i.e., 43% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,669 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.1. This one is in the 49th percentile – i.e., 49% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 310,508 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.
We're also able to compare this research output to 53 others from the same source and published within six weeks on either side of this one. This one is in the 47th percentile – i.e., 47% of its contemporaries scored the same or lower than it.