Thirty-five normal cadaver knees were tested manually in six positions
of the knee using apparatus designed to measure the moment-rotation
responses for both varus-valgus angulation and torsion of the tibia, as
well as the force-displacement responses for anterior-posterior movement of
the tibia. The responses of all knees to all modes of loading were
non-linear, reflecting increasing stiffness. With the knee at full
extension, stiffness was maximum and laxity was minimum. Hence, it was in
this position that changes in stability (laxity and stiffness) were best
demonstrated when ligament structures were sectioned. Differences in laxity
were observed between right and left knees of intact paired specimens.
Torsional laxity and internal rotation stiffness were most affected by
sectioning the medial collateral ligament, while external rotation
stiffness was only affected by division of both the lateral collateral
ligament and the posterior capsule. Varus-valgus laxity was relatively
unaffected by removal of the menisci or section of the cruciate ligaments
but increased greatly when either collateral ligament was cut. The medial
collateral ligament was the main contributor to valgus stiffness, whereas
the lateral collateral ligament had no measurable effect on varus
stiffness. Anterior-posterior stability was affected to some extent by
virtually every sectioning procedure. Isolated section of the anterior
cruciate ligament produced the greatest increase in anterior-posterior
laxity at full extension and section of the posterior cruciate, the
greatest increase at 90 degrees of flexion. Large increases in
anterior-posterior laxity were also observed when the medial collateral
ligament and posterior capsule were sectioned in combination.