Author:
Ott Nadine,Harland Arne,Lanzerath Fabian,Leschinger Tim,Hackl Michael,Wegmann Kilian,Müller Lars Peter
Abstract
Abstract
Background
Lateral collateral ligament (LCL) tears are frequently observed in fractures and dislocations of the elbow. Recent biomechanical evidence suggests that additional ligament augmentation may improve repair stability. The aim of this biomechanical in-vitro study was to compare the resistance of a locking suture repair of the LCL with a ligament augmentation technique.
Material and methods
Eight fresh frozen cadaveric elbows were evaluated for stability against varus/posterolateral rotatory forces (3 Nm). A strain gauge (µm/m; negative values) was placed at the origin and insertion of the lateral ulnar collateral ligament (LUCL) and cyclic loading was performed for 1000 cycles. We analyzed three distinct scenarios: (A) native LCL, (B) locking transosseou suture repair of the LCL, (C) simple LCL repair with additional ligament augmentation of the LUCL.
Results
The mean measured strain was − 416.1 µm/m (A), − 618 µm/m (B) and − 288.5 µm/m (C) with the elbow flexion at 90°; the strain was significantly higher in scenario B compared to C (p = .01). During the cyclic load (1000) the mean measured strain was − 523.1 µm/m (B) and − 226.3 µm/m (C) with the elbow flexion at 60°; the strain was significantly higher in scenario B compared to C (p = .01). No significant difference between the first and the last cycles was observed (p = .09; p = .07). One failure of the LCL repair was observed after 1000 cycles; none of the ligament augmentations failed.
Conclusion
Ligament augmentation (C) provides higher resistance compared to the native LCL (A) and to the locking suture repair technique (B). Both techniques, however, hold up during 1000 cycles. While ligament augmentation might enhance the primary stability of the repair, future clinical studies have to show whether this increase in resistance leads to negative effects like higher rates of posttraumatic elbow stiffness.
Level of evidence
Basic science study, biomechanics.
Publisher
Springer Science and Business Media LLC
Subject
Orthopedics and Sports Medicine,General Medicine,Surgery,Surgery
Cited by
4 articles.
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