title: Biomechanical study of strength and stiffness of the knee anterolateral ligament.
abstract: BACKGROUND
  Recent studies clearly characterize the anatomical parameters of the knee anterolateral ligament (ALL). The potential clinical importance of this ligament is exemplified by some patients with possible combined Anterior Cruciate Ligament (ACL) and ALL rupture who do not progress satisfactorily following isolated ACL reconstruction. Previous biomechanical studies have assessed the resistance parameters of the ALL in order to address potential reconstruction strategies; however, these have reported conflicting results. Thus, this study aimed to evaluate the linear resistance of the ALL by means of a biomechanical study in cadaveric knees.
  
  
  METHODS
  Fourteen cadaveric knees were used. The ALL was dissected, and all structures that connect the femur and the tibia, except for the ALL, were sectioned. The ALL was subjected to a tensile test with the knee around 30 to 40 degrees, in a way that the ALL was aligned with the machine. The strength at the maximum resistance limit, deformation and stiffness of the ALL were evaluated.
  
  
  RESULTS
  The mean maximum strength of the ALL was 204.8 +/- 114.9 N. The stiffness was 41.9 +/- 25.7 N/mm and the deformation 10.3 +/- 3.5 mm.
  
  
  CONCLUSIONS
  The ALL has a mean ultimate tensile strength of 204.8 N. This suggests that simple bands of all autologous or homologous grafts commonly used in clinical practice for ligament reconstruction around the knee possess the required biomechanical resistance characteristics for ALL reconstruction.
authors.affiliation: Knee Surgery Division, Department of Orthopaedics and Traumatology, Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo (IOT-HCFMUSP), São Paulo, Brazil. Camilo_helito@yahoo.com.br.|, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira Cesar, São Paulo SP, CEP: 05403-010, Brazil. Camilo_helito@yahoo.com.br.
authors.forename: Camilo Partezani
authors.initials: CP
authors.lastname: Helito
authors.affiliation: Knee Surgery Division, Department of Orthopaedics and Traumatology, Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo (IOT-HCFMUSP), São Paulo, Brazil.
authors.forename: Marcelo Batista
authors.initials: MB
authors.lastname: Bonadio
authors.affiliation: Department of Orthopaedic Surgery, Catholic University of São Paulo, Sorocaba, São Paulo, Brazil.
authors.forename: João Stefan
authors.initials: JS
authors.lastname: Rozas
authors.affiliation: Department of Orthopaedic Surgery, Catholic University of São Paulo, Sorocaba, São Paulo, Brazil.
authors.forename: João Marcelo Pedroso
authors.initials: JM
authors.lastname: Wey
authors.affiliation: Biomechanical Laboratory Division, Department of Orthopaedics and Traumatology, Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo (IOT-HCFMUSP), São Paulo, Brazil.
authors.forename: Cesar Augusto Martins
authors.initials: CA
authors.lastname: Pereira
authors.affiliation: Department of Orthopaedic Surgery, Catholic University of São Paulo, Sorocaba, São Paulo, Brazil.
authors.forename: Tulio Pereira
authors.initials: TP
authors.lastname: Cardoso
authors.affiliation: Knee Surgery Division, Department of Orthopaedics and Traumatology, Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo (IOT-HCFMUSP), São Paulo, Brazil.
authors.forename: José Ricardo
authors.initials: JR
authors.lastname: Pécora
authors.affiliation: Knee Surgery Division, Department of Orthopaedics and Traumatology, Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo (IOT-HCFMUSP), São Paulo, Brazil.
authors.forename: Gilberto Luis
authors.initials: GL
authors.lastname: Camanho
authors.affiliation: Knee Surgery Division, Department of Orthopaedics and Traumatology, Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo (IOT-HCFMUSP), São Paulo, Brazil.
authors.forename: Marco Kawamura
authors.initials: MK
authors.lastname: Demange
mesh_terms: D000368:Aged; D016118:Anterior Cruciate Ligament / Q000473:pathology / Q000502:physiology*; D001696:Biomechanical Phenomena / Q000502:physiology*; D006801:Humans; D007719:Knee Joint / Q000473:pathology / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D013718:Tensile Strength / Q000502:physiology*
keywords: Anatomy; Anterolateral ligament; Biomechanics; Knee