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, 19 (5), 719-27

In Vivo Length Patterns of the Medial Collateral Ligament During the Stance Phase of Gait

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In Vivo Length Patterns of the Medial Collateral Ligament During the Stance Phase of Gait

Fang Liu et al. Knee Surg Sports Traumatol Arthrosc.

Abstract

Purpose: The function of the medial collateral ligament (MCL) during gait has not been investigated. Our objective was to measure the kinematics of the medial collateral ligament during the stance phase of gait on a treadmill using a combined dual fluoroscopic imaging system (DFIS) and MRI technique.

Methods: Three-dimensional models of the knee were constructed using magnetic resonance images of 7 healthy human knees. The contours of insertion areas of the superficial MCL (sMCL) and deep MCL (dMCL) on the femur and tibia were constructed using the coronal plane MR images of each knee. Both the sMCL and the dMCL were separated into 3 portions: the anterior, mid, and posterior bundles. The relative elongation of the bundles was calculated using the bundle length at heel strike (or 0% of the stance phase) as a reference.

Results: The lengths of the anterior bundles were positively correlated with the knee flexion angle. The mid-bundles of the sMCL and dMCL were found to function similarly in trend with the anterior bundles during the stance phase of the gait and their lengths had weak correlations with the knee flexion angles. The elongations of the posterior bundles of sMCL and dMCL were peaked at mid-stance and terminal extension/pre-swing stance phase. The lengths of the posterior bundles were negatively correlated with the knee flexion during the stance phase.

Conclusion: The data of this study demonstrated that the anterior and posterior bundles of the sMCL and dMCL have a reciprocal function during the stance phase of gait. This data provide insight into the function of the MCL and a normal reference for the study of physiology and pathology of the MCL. The data may be useful in designing reconstruction techniques to better reproduce the native biomechanical behavior of the MCL.

Level of evidence: IV.

Figures

Fig. 1
Fig. 1
A typical 3D model of the knee created from sagittal plane MRI. a lateral view of a knee model shows the attachment of the sMCL and dMCL; b AP view of a knee model. a, the direct line between the centroid of attachment of sMCL; b, the direct line is projected on the bony surfaces to create a curved ligament
Fig. 2
Fig. 2
The elongation of the anterior (a), mid (b), and posterior (c) portions of the sMCL during the stance phase of gait. (LR loading response, MST mid-stance, TST terminal stance, PSW pre-swing) An asterisk indicates a statistically significant difference (P<0.05)
Fig. 3
Fig. 3
Correlation between the relative elongations of the sMCL portions and the knee flexion angle during the stance phase of gait. a elongation of the anterior portion is positively correlated with the knee flexion angle, b mid-portion, c elongation of the posterior portion is negatively correlated with the knee flexion angle
Fig. 4
Fig. 4
The elongation of the anterior (a), mid (b), and posterior (c) portions of the dMCL during the stance phase of gait. An asterisk indicates a statistically significant difference (P<0.05)
Fig. 5
Fig. 5
Correlation between the relative elongations of the dMCL portions and the knee flexion angle during the stance phase of gait. a elongation of the anterior portion is positively correlated with the knee flexion angle, b mid-portion, c elongation of the posterior portion is negatively correlated with the knee flexion angle

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