Universität zu Köln

Ott, Nadine, Harland, Arne, Lanzerath, Fabian, Leschinger, Tim, Hackl, Michael, Wegmann, Kilian and Muller, Lars Peter (2023). Locking suture repair versus ligament augmentation-a biomechanical study regarding the treatment of acute lateral collateral ligament injuries of the elbow. Arch. Orthop. Trauma Surg., 143 (2). S. 857 - 864. NEW YORK: SPRINGER. ISSN 1434-3916

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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 (mu m/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 mu m/m (A), - 618 mu m/m (B) and - 288.5 mu m/m (C) with the elbow flexion at 90 degrees; 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 mu m/m (B) and - 226.3 mu m/m (C) with the elbow flexion at 60 degrees; 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ott, Nadine UNSPECIFIED UNSPECIFIED UNSPECIFIED Harland, Arne UNSPECIFIED UNSPECIFIED UNSPECIFIED Lanzerath, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Leschinger, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED Hackl, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Muller, Lars Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-657079
DOI:	10.1007/s00402-022-04337-0
Journal or Publication Title:	Arch. Orthop. Trauma Surg.
Volume:	143
Number:	2
Page Range:	S. 857 - 864
Date:	2023
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1434-3916
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSTEROLATERAL ROTATORY INSTABILITY; RECONSTRUCTION; STABILITY; RESTORES; ANATOMY; VARUS Multiple languages Orthopedics; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/65707