Mapping of Contributions From Collateral Ligaments to Overall Knee Joint Constraint: An Experimental Cadaveric Study

Abstract

Understanding the contribution of the soft-tissues to total joint constraint (TJC) is important for predicting joint kinematics, developing surgical procedures, and increasing accuracy of computational models. Previous studies on the collateral ligaments have focused on quantifying strain and tension properties under discrete loads or kinematic paths; however, there has been little work to quantify collateral ligament contribution over a broad range of applied loads and range of motion (ROM) in passive constraint. To accomplish this, passive envelopes were collected from nine cadaveric knees instrumented with implantable pressure transducers (IPT) in the collateral ligaments. The contributions from medial and lateral collateral ligaments (LCL) were quantified by the relative contribution of each structure at various flexion angles (0–120 deg) and compound external loads (±10 N m valgus, ±8 N m external, and ±40 N anterior). Average medial collateral ligament (MCL) contributions were highest under external and valgus torques from 60 deg to 120 deg flexion. The MCL showed significant contributions to TJC under external torques throughout the flexion range. Average LCL contributions were highest from 0 deg to 60 deg flexion under external and varus torques, as well as internal torques from 60 deg to 110 deg flexion. Similarly, these regions were found to have statistically significant LCL contributions. Anterior and posterior loads generally reduced collateral contribution to TJC; however, posterior loads further reduced MCL contribution, while anterior loads further reduced LCL contribution. These results provide insight to the functional role of the collaterals over a broad range of passive constraint. Developing a map of collateral ligament contribution to TJC may be used to identify the effects of injury or surgical intervention on soft-tissue, and how collateral ligament contributions to constraint correlate with activities of daily living.