Reconstruction of the ligamentous-tendinous complex of the knee joint, ensuring its varus stability
- Authors: Khominets V.V.1, Kudyashev A.L.1, Gaivoronskiy I.V.1, Bazarov I.S.1, Grankin A.S.1, Semenov A.A.1, Konokotin D.A.1
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Affiliations:
- Military medical academy of S.M. Kirov
- Issue: Vol 24, No 1 (2022)
- Pages: 61-68
- Section: Research paper
- URL: https://journals.rcsi.science/1682-7392/article/view/87931
- DOI: https://doi.org/10.17816/brmma87931
- ID: 87931
Cite item
Abstract
А new technique for anatomical reconstruction of the ligament–tendon complex of the knee joint, which restores its varus stability, in patients with multiligament injury is substantiated. The technical feasibility, safety, and effectiveness of the proposed technique were evaluated in an anatomical experiment. The study was performed on eight lower extremities of four unfixed corpses. After simulating the varus instability of the knee joint, the plasty of the ligament–tendon complex providing the varus stability of the knee joint was performed according to the proposed technique. The essence of the proposed technique is the simultaneous restoration of the peroneal collateral ligament, popliteal tendon, and popliteal–peroneal ligament using a single autograft of a semitendinosus muscle. After simulating the surgical procedure on anatomical specimens, the varus stability of the knee joint was evaluated based on the results of functional radiography. The safety of the experimental procedure was evaluated based on the results of the applied morphometric study of the distance from the reconstructed elements of the posterolateral corner of the knee joint to the popliteal artery and the common peroneal nerve in the 90-degree flexion position in the knee joint. Accordingly, the formed bone tunnels for a single autograft were located at a safe distance from the elements of the neurovascular bundle of the popliteal fossa. The technical possibility of reconstruction of the collateral peroneal ligament, popliteal tendon, and popliteal–peroneal ligament according to the proposed technique. After simulating the reconstruction of elements of the posterolateral corner of the knee joint, varus stability was objectified by a series of functional X-ray studies of the anatomical specimens. The results indicate the technical feasibility, effectiveness, and relative safety of the proposed method of reconstruction of the ligament–tendon complex of the posterolateral corner of the knee joint providing the varus stability of the knee joint in patients with multiligament injury.
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##article.viewOnOriginalSite##About the authors
Vladimir V. Khominets
Military medical academy of S.M. Kirov
Email: khominets_62@mail.ru
ORCID iD: 0000-0001-9391-3316
SPIN-code: 5174-4433
Scopus Author ID: 6504618617
doctor of medical sciences, professor
Russian Federation, Saint PeterburgAleksey L. Kudyashev
Military medical academy of S.M. Kirov
Email: a.kudyashev@gmail.com
ORCID iD: 0000-0002-8561-2289
SPIN-code: 6138-0950
doctor of medical sciences, associate professor
Russian Federation, Saint PeterburgIvan V. Gaivoronskiy
Military medical academy of S.M. Kirov
Email: i.v.gaivoronsky@mail.ru
ORCID iD: 0000-0002-6836-5650
SPIN-code: 1898-3355
doctor of medical sciences, professor
Russian Federation, Saint PeterburgIvan S. Bazarov
Military medical academy of S.M. Kirov
Email: dok055@yandex.ru
ORCID iD: 0000-0002-4708-493X
SPIN-code: 4745-2901
head of department
Russian Federation, Saint PeterburgAleksey S. Grankin
Military medical academy of S.M. Kirov
Email: aleksey-grankin@yandex.ru
ORCID iD: 0000-0002-4565-9066
SPIN-code: 1122-8388
candidate of medical sciences
Russian Federation, Saint PeterburgAleksey A. Semenov
Military medical academy of S.M. Kirov
Author for correspondence.
Email: semfeodosia82@mail.ru
SPIN-code: 1147-3072
candidate of medical sciences
Russian Federation, Saint PeterburgDmitri A. Konokotin
Military medical academy of S.M. Kirov
Email: konokotin.dmirty@yandex.ru
ORCID iD: 0000-0003-3100-0321
SPIN-code: 1625-0543
Adjunct
Russian Federation, Saint PeterburgReferences
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