title: Treatment of ligament laxity by electrothermal shrinkage or surgical plication: a morphologic and mechanical comparison.
abstract: Capsular plication or thermal shrinkage can be used to enhance surgical joint stabilization. We compared mechanical or morphologic properties of the medial collateral ligament of the rabbit knee treated by either bipolar radiofrequency electrothermal shrinkage or surgical plication. After 12 weeks, the medial collateral ligaments were procured from treated and contralateral knees to undergo viscoelastic (creep) testing, quantitative transmission electron microscopy, and immunohistochemistry. Creep strain in thermal (1.85% +/- 0.32%) and plicated (1.92% +/- 0.36%) ligaments was almost twice that of the control group (1.04% +/- 0.15%), although there was no difference between treatment modalities. The morphologic parameters of all 3 groups were significantly different (P < .001). The thermal ligaments demonstrated predominantly small fibrils, whereas the plicated group displayed an intermediate distribution of heterogeneous fibrils, suggesting a different pattern of remodeling. Viscoelastic properties are similar after thermal shrinkage or plication, though inferior to those of intact ligaments.
authors.affiliation: Department of Musculoskeletal Surgery, Imperial College London, London, England, UK.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Hill
authors.forename: Ioan T
authors.initials: IT
authors.lastname: Jones
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hansen
authors.forename: Amrita
authors.initials: A
authors.lastname: Suri
authors.forename: Ann
authors.initials: A
authors.lastname: Sandison
authors.forename: Jill
authors.initials: J
authors.lastname: Moss
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Wallace
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D017885:Collateral Ligaments / Q000601:surgery* / Q000648:ultrastructure; D004564:Electrocoagulation; D005260:Female; D007593:Joint Instability / Q000601:surgery*; D007719:Knee Joint; D046529:Microscopy, Electron, Transmission; D019637:Orthopedic Procedures / Q000379:methods; D011817:Rabbits