Featured Research

from universities, journals, and other organizations

Study Sheds Light On "Dark Side" Of The Knee

Date:
July 8, 2002
Source:
Duke University Medical Center
Summary:
As orthopedic surgeons come to appreciate the important role of the so-called "dark side of the knee" in the failure of reconstructive knee surgeries, laboratory research led by a Duke University Medical Center investigator has determined the optimal surgical approach to improve the outcomes of these reconstructive surgeries.

ORLANDO, FLA -- As orthopedic surgeons come to appreciate the important role of the so-called "dark side of the knee" in the failure of reconstructive knee surgeries, laboratory research led by a Duke University Medical Center investigator has determined the optimal surgical approach to improve the outcomes of these reconstructive surgeries.

Knee damage is the most common sports injury and it usually occurs when there is a tear or break in at least one of the four ligaments of the knee, the most common being the anterior cruciate ligament (ACL). Orthopedic surgeons will often reconstruct the joint using tissue from the patient or a cadaver. While the surgery and subsequent rehabilitation returns about 90 percent of patients to normal sporting activity, surgeons are finding that instability in a little-studied area of the knee -- the posterolateral corner -- is a leading cause of knee reconstruction failures. The posterolateral corner is the outside region of the knee just posterior to the kneecap.

"To our knowledge, no one has studied the two accepted procedures for dealing with the instability in this 'dark side' of the knee," said Claude T. Moorman III, M.D., orthopedic surgeon and director of the sports medicine program at Duke, who led a team of researchers from the University of Maryland, Johns Hopkins University and University of Alabama-Birmingham. "While both surgical approaches are effective, our analysis shows that a simpler and quicker approach may be the better of the two."

The results of the team's study were prepared for presentation today (July 1, 2002) at the 28th annual meeting of the American Orthopedic Society for Sports Medicine (AOSSM). The study received the 2002 Aircast Award for Basic Science, given annually by the AOSSM. The study was funded by University of the Maryland Sports Medicine, where Moorman served prior to coming to Duke last year.

"This posterolateral corner has been referred to as the 'dark side' of the knee because it is poorly understood and treatment for these injuries has not been consistently successful," Moorman said. "Now, as a result of this comparison, we have a straightforward and predictable approach to successfully restore knee stability to its normal state."

The knee is a complex joint, in which a series of ligaments, tendons and cartilage create a "hinge" where the femur, the upper leg bone, connects with the two bones of lower leg, the larger tibia and the smaller fibula. The kneecap, or patella, protects the joint. When the posterolateral corner is not aligned properly after reconstruction, the tibia and femur rotate more than normal, which puts undo forces on the joint and leads to the failure of the reconstruction.

To compare the benefits of the two most commonly used procedures to address this instability, the team used 12 pairs of fresh cadaveric knees. After performing each of the two surgeries on one knee of the pair, the knees were then attached to a device in the laboratory that can simulates the pressures and torques experienced by the knee.

The first approach, known as the combined tibial and fibular-based reconstruction, uses cadaveric tendon to make two attachments: from the femur to both the fibula and tibia. In the second approach, called the fibular-based reconstruction, a portion of patient's tendon is used to make a figure-eight connection from the femur to the fibula. (See attached drawings.)

"After testing both approaches in the laboratory, we found that both can successfully restore stability to the knee, but the fibular-based has the advantages of being an easier procedure, taking less time in the operating room, and causing fewer surgical complications," Moorman said.

Moorman added that the benefits of the cadaveric (allograft) source over the patient (autograft) source of tendon are still a matter of debate among surgeons. While the harvest of autograft tissue involves another incision, the quality of the tissue is usually better and there is no risk of disease transmission, Moorman said. Further clinical trials are needed to determine the best source of tissue, he added.

"While many techniques have been considered and used in clinical practice, few have been critically evaluated by biomechanical studies to determine their ability to restore normal knee functions," Moorman said. "Our study provides guidance for orthopedic surgeons who treat this difficult injury pattern."

Other members of the team included Peter Rauh, M.D., and Leigh Ann Curl, M.D., of the University of Maryland; Louis Jasper and Stephen Belkoff, Ph.D., Johns Hopkins University; and W.G. Clancy, M.D., University of Alabama-Birmingham.


Story Source:

The above story is based on materials provided by Duke University Medical Center. Note: Materials may be edited for content and length.


Cite This Page:

Duke University Medical Center. "Study Sheds Light On "Dark Side" Of The Knee." ScienceDaily. ScienceDaily, 8 July 2002. <www.sciencedaily.com/releases/2002/07/020708082242.htm>.
Duke University Medical Center. (2002, July 8). Study Sheds Light On "Dark Side" Of The Knee. ScienceDaily. Retrieved October 2, 2014 from www.sciencedaily.com/releases/2002/07/020708082242.htm
Duke University Medical Center. "Study Sheds Light On "Dark Side" Of The Knee." ScienceDaily. www.sciencedaily.com/releases/2002/07/020708082242.htm (accessed October 2, 2014).

Share This



More Health & Medicine News

Thursday, October 2, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Might Not Be Out Of Control In U.S., But Coverage Is

Ebola Might Not Be Out Of Control In U.S., But Coverage Is

Newsy (Oct. 2, 2014) Coverage of the lone Ebola patient discovered in Texas has U.S. media in a frenzy — but does the coverage match the reality? Video provided by Newsy
Powered by NewsLook.com
US Hunts Contacts of Ebola Patient, Including Children

US Hunts Contacts of Ebola Patient, Including Children

AFP (Oct. 2, 2014) Health officials in Texas on Wednesday scoured the Dallas area for people, including schoolchildren, who came in contact with a Liberian man who was diagnosed with Ebola in the United States. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com
Study Says Losing Sense Of Smell Can Indicate Death

Study Says Losing Sense Of Smell Can Indicate Death

Newsy (Oct. 2, 2014) Researchers found elderly adults with a poor sense of smell are more likely to die within five years. Video provided by Newsy
Powered by NewsLook.com
Pregnancy Spacing Could Have Big Impact On Autism Risks

Pregnancy Spacing Could Have Big Impact On Autism Risks

Newsy (Oct. 1, 2014) A new study says children born less than one year and more than five years after a sibling can have an increased risk for autism. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins