The mechanical characteristics of the collateral ligaments of the human ankle joint

In the present study, the tensile mechanical properties of all of the collateral ligaments of the human ankle joint were determined, in vitro, from tensile tests conducted on 120 ligaments obtained from 20 fresh lower limbs. The ultimate load of the lateral collateral ligaments increased in an anteroposterior sequence, with the anterior fibulotalar ligament less than the fibulocalcaneal ligament and less than the posterior fibulotalar ligament. For the medial collateral ligaments, the increasing order of ultimate load was found to be tibiocalcaneal ligament, tibionavicular ligament, tibiospring ligament, posterior tibiotalar ligament. The posterior tibiotalar ligament and tibiospring ligament, so frequently neglected in the anatomical and orthopaedic literature, demonstrated the highest yield force and ultimate load of all of the collateral ligaments of the ankle. Additionally, the tibiospring ligament showed high yield and ultimate elongation properties probably related to its distal attachment to the spring ligament. The fibulocalcaneal ligament was found to have high linear elastic modulus suggesting some type of unique material properties or internal fiber organization. Knowledge of the mechanical characteristics of the ligaments of the ankle joint contributes to an understanding of their normal function, pathomechanics of injury, and their optimal surgical reparative procedure and reconstructive material. A knowledge of the normal mechanical properties of the ankle ligaments provides a data base to evaluate which of the multiplicity of present tendon graft materials has mechanical properties similar to those of the ligaments to be replaced. Those tendon grafts will be the most suitable for replacement of specific ligaments. Finally, data on the mechanical properties of these ligaments offer the possibility for evaluating any future biological or prosthetic grafts.