{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:30:44Z","timestamp":1792510244124,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:00:00Z","timestamp":1709769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the forces on a medial collateral ligament (MCL) reconstruction (MCLR) relative to the valgus alignment of the knee.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eight fresh\u2010frozen human cadaveric knees were subjected to dynamic valgus loading at 400 N using a custom\u2010made kinematics rig. After resection of the superficial medial collateral ligament, a single\u2010bundle MCLR with a hamstring tendon autograft was performed. A medial opening wedge distal femoral osteotomy was performed and fixed with an external fixator to gradually adjust the alignment in 5\u00b0\u00a0increments from 0\u00b0 to 10\u00b0 valgus. For each degree of valgus deformity, the resulting forces acting on the MCLR were measured through a force sensor and captured in 15\u00b0 increments from 0\u00b0 to 60\u00b0 of knee flexion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Irrespective of the degree of knee flexion, increasing valgus malalignment resulted in significantly increased forces acting on the MCLR compared to neutral alignment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Dynamic loading at 5\u00b0 valgus resulted in increased forces on the MCLR at all flexion angles ranging between 16.2 N\u00a0and 18.5\u2009N (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 from 0\u00b0 to 30\u00b0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01 from 45\u00b0 to 60\u00b0). A 10\u00b0 valgus malalignment further increased the forces on the MCLR at all flexion angles ranging between 29.4 N\u00a0and 40.0\u2009N (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01 from 0\u00b0 to 45\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 at 60\u00b0).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Valgus malalignment of the knee caused increased forces acting on the reconstructed MCL. In cases of chronic medial instabilities accompanied by a valgus deformity\u2009\u2265\u20095\u00b0, a realigning osteotomy should be considered concomitantly to the MCLR to protect the graft and potentially reduce graft failures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.12110","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T02:58:30Z","timestamp":1709866710000},"page":"864-871","source":"Crossref","is-referenced-by-count":15,"title":["Valgus malalignment causes increased forces on a medial collateral ligament reconstruction under dynamic valgus loading: A\u00a0biomechanical study"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8055-289X","authenticated-orcid":false,"given":"Christian","family":"Peez","sequence":"first","affiliation":[{"name":"Department of Trauma, Hand and Reconstructive Surgery University Hospital M\u00fcnster M\u00fcnster Germany"},{"name":"AO Research Institute Davos Davos Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Deichsel","sequence":"additional","affiliation":[{"name":"Department of Trauma, Hand and Reconstructive Surgery University Hospital M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Zderic","sequence":"additional","affiliation":[{"name":"AO Research Institute Davos Davos Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Geoff","family":"Richards","sequence":"additional","affiliation":[{"name":"AO Research Institute Davos Davos Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyko","family":"Gueorguiev","sequence":"additional","affiliation":[{"name":"AO Research Institute Davos Davos Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Kittl","sequence":"additional","affiliation":[{"name":"Department of Trauma, Hand and Reconstructive Surgery University Hospital M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Raschke","sequence":"additional","affiliation":[{"name":"Department of Trauma, Hand and Reconstructive Surgery University Hospital M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elmar","family":"Herbst","sequence":"additional","affiliation":[{"name":"Department of Trauma, Hand and Reconstructive 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