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Article

Biomechanical Analysis of Internal Bracing for Treatment of Medial Knee Injuries

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Citation

Gilmer BB, Crall T, DeLong J, Kubo T, Mackay G & Jani SS (2016) Biomechanical Analysis of Internal Bracing for Treatment of Medial Knee Injuries. Orthopedics, 39 (3), pp. e532-e537. https://doi.org/10.3928/01477447-20160427-13

Abstract
The internal brace technique uses a high-strength suture tie to augment injured tissues or a primary repair, allowing early rehabilitation. Anatomic repair with internal bracing is a novel and promising treatment for femoral-sided medial knee avulsion injuries of the medial collateral ligament and posterior oblique ligament. Unfortunately, biomechanical and clinical data are lacking. To evaluate this technique compared with other treatment options, 3 assays of 9 cadaveric matched pairs (54 knees) were tested to failure at 30¡ã under valgus load in a biomechanical testing apparatus. The primary outcome measure was moment at failure (Nm), with secondary outcome measures of stiffness (Nm/¡ã), valgus angulation at 10 Nm (¡ã), and valgus angulation at failure (¡ã). Repair with internal bracing was compared with the intact state, repair alone, and allograft reconstruction. The mean moment to failure (62.5¡À24.9 Nm) for internal bracing was significantly lower than that for intact specimens (107.2¡À39.7 Nm) (P=.009). Mean moment to failure and valgus angle at failure were significantly greater for internal bracing (95¡À31.9 Nm) than for repair (73.4¡À27.6 Nm) (P=.05). Internal bracing was similar to reconstruction for the primary outcome measure (53.5¡À26.3 Nm vs 66.9¡À28.8 Nm) (P=.227) and for all secondary outcome measures. These findings indicate that posteromedial knee repair with internal bracing for femoral-sided avulsions is superior to repair alone and is similar to allograft reconstruction for all parameters measured; however, this technique did not recreate biomechanical properties equivalent to the intact state.

Journal
Orthopedics: Volume 39, Issue 3

StatusPublished
Publication date31/12/2016
Publication date online02/05/2016
Date accepted by journal04/11/2015
PublisherHealio
ISSN0147-7447
eISSN1938-2367