The Medial structures of the knee have a significant contribution to posteromedial rotational laxity control in the PCL‐deficient knee
Bibliographic record
Abstract
PURPOSE: Various reconstruction techniques have been employed to restore normal kinematics to PCL-deficient knees; however, studies show that failure rates are still high. Damage to secondary ligamentous stabilizers of the joint, which commonly occurs concurrently with PCL injuries, may contribute to these failures. The main objective of this study was to quantify the biomechanical contributions of the deep medial collateral ligament (dMCL) and posterior oblique ligament (POL) in stabilizing the PCL-deficient knee, using a joint motion simulator. METHODS: Eight cadaveric knees underwent biomechanical analysis of posteromedial stability and rotatory laxity using an AMTI VIVO joint motion simulator. Combined posterior force (100 N) and internal torque (5 Nm) loads, followed by pure internal/external torques (± 5 Nm), were applied at 0, 30, 60 and 90° of flexion. The specimens were tested in the intact state, followed by sequential sectioning of the PCL, dMCL, POL and sMCL. The order of sectioning of the dMCL and POL was randomized, providing n = 4 for each cutting sequence. Changes in posteromedial displacements and rotatory laxities were measured, as were the biomechanical contributions of the dMCL, POL and sMCL in resisting these loads in a PCL-deficient knee. RESULTS: Overall, it was observed that POL transection caused increased posteromedial displacements and internal rotations in extension, whereas dMCL transection had less of an effect in extension and more of an effect in flexion. Although statistically significant differences were identified during most loading scenarios, the increases in posteromedial displacements and rotatory laxity due to transection of the POL or dMCL were usually small. However, when internal torque was applied to the PCL-deficient knee, the combined torque contributions of the dMCL and POL towards resisting rotation was similar to that of the sMCL. CONCLUSION: The dMCL and POL are both important secondary stabilizers to posteromedial translation in the PCL-deficient knee, with alternating roles depending on flexion angle. Thus, in a PCL-deficient knee, concomitant injuries to either the POL or dMCL should be addressed with the aim of reducing the risk of PCL reconstruction failure.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".