{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T00:29:41Z","timestamp":1793752181644,"version":"4.6.1"},"reference-count":38,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T00:00:00Z","timestamp":1591315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T00:00:00Z","timestamp":1591315200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T00:00:00Z","timestamp":1591315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100009026","name":"Smith and Nephew","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009026","name":"Smith and Nephew","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this study was to determine the contribution of each of the ACL and medial ligament structures in resisting anteromedial rotatory instability (AMRI) loads applied in vitro.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twelve knees were tested using a robotic system. It imposed loads simulating clinical laxity tests at 0\u00b0 to 90\u00b0 flexion:\u2009\u00b190\u00a0N anterior\u2013posterior force, \u00b18\u00a0Nm varus\u2013valgus moment, and \u00b15\u00a0Nm internal\u2013external rotation, and the tibial displacements were measured in the intact knee. The ACL and individual medial structures\u2014retinaculum, superficial and deep medial collateral ligament (sMCL and dMCL), and posteromedial capsule with oblique ligament (POL\u2009+\u2009PMC)\u2014were sectioned sequentially. The tibial displacements were reapplied after each cut and the reduced loads required allowed the contribution of each structure to be calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For anterior translation, the ACL was the primary restraint, resisting 63\u201377% of the drawer force across 0\u00b0 to 90\u00b0, the sMCL contributing 4\u20137%. For posterior translation, the POL\u2009+\u2009PMC contributed 10% of the restraint in extension; other structures were not significant. For valgus load, the sMCL was the primary restraint (40\u201354%) across 0\u00b0 to 90\u00b0, the dMCL 12%, and POL\u2009+\u2009PMC 16% in extension. For external rotation, the dMCL resisted 23\u201313% across 0\u00b0 to 90\u00b0, the sMCL 13\u201322%, and the ACL 6\u20139%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The dMCL is the largest medial restraint to tibial external rotation in extension. Therefore, following a combined ACL\u2009+\u2009MCL injury, AMRI may persist if there is inadequate healing of both the sMCL and dMCL, and MCL deficiency increases the risk of ACL graft failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00167-020-06084-4","type":"journal-article","created":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T11:03:44Z","timestamp":1591355024000},"page":"3700-3708","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":117,"title":["The medial ligaments and the ACL restrain anteromedial laxity of the knee"],"prefix":"10.1002","volume":"28","author":[{"given":"S.","family":"Ball","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Fortius Clinic London UK"},{"name":"<!--<label>2<\/label>--> Orthopaedic Surgery Department Chelsea and Westminster Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M.","family":"Stephen","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Fortius Clinic London UK"},{"name":"<!--<label>3<\/label>--> Biomechanics Group, Mechanical Engineering Department Imperial College London SW7 2AZ London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"El\u2010Daou","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Biomechanics Group, Mechanical Engineering Department Imperial College London SW7 2AZ London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Williams","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Fortius Clinic London UK"},{"name":"<!--<label>3<\/label>--> Biomechanics Group, Mechanical Engineering Department Imperial College London SW7 2AZ London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew A.","family":"Amis","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Biomechanics Group, Mechanical Engineering Department Imperial College London SW7 2AZ London UK"},{"name":"<!--<label>4<\/label>--> Musculoskeletal Surgery Group Imperial College London School of Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,5]]},"reference":[{"key":"e_1_2_9_2_2","first-page":"96","volume-title":"EFORT European instructional course lectures","author":"Amis AA","year":"1999"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010198062020\u201000013"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/joa.12087"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010198567050\u201000006"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.96B3.33033"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.medengphy.2017.06.012"},{"key":"e_1_2_9_8_2","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1097\/00003086-197805000-00038","article-title":"Medial collateral ligament injuries of the knee: a rationale for treatment","volume":"132","author":"Fetto JF","year":"1978","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010018\u20105072\u20106"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519896333"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509333852"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010198163080\u201000007"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354659402200317"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010197355050\u201000002"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010198365030\u201000005"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516681555"},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518756328"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010197153070\u201000001"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515614312"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.09.006"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00132588\u2010200212000\u201000008"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.92B7.23559"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518764681"},{"key":"e_1_2_9_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2004.05.034"},{"key":"e_1_2_9_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506289433"},{"key":"e_1_2_9_26_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.86B5.14853"},{"key":"e_1_2_9_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021\u20109290(96)00056\u20105"},{"key":"e_1_2_9_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515623510"},{"key":"e_1_2_9_29_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010199173020\u201000013"},{"key":"e_1_2_9_30_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010196850020\u201000001"},{"key":"e_1_2_9_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516686057"},{"key":"e_1_2_9_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010018\u20105237\u20103"},{"key":"e_1_2_9_33_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports\u20102014\u2010094573"},{"key":"e_1_2_9_34_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010197961010\u201000011"},{"key":"e_1_2_9_35_2","unstructured":"WiererG MilinkovicD RobinsonJRet al. 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