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  • Title: Is the pie-crusting technique safe for MCL release in varus deformity correction in total knee arthroplasty?
    Author: Meneghini RM, Daluga AT, Sturgis LA, Lieberman JR.
    Journal: J Arthroplasty; 2013 Sep; 28(8):1306-9. PubMed ID: 23680500.
    Abstract:
    Established for lateral release in TKA, the pie-crusting technique has not been studied for the medial collateral ligament (MCL). In cadaveric knees the MCL was release with a pie-crusting technique in one and traditional technique in the contralateral knee. Along with a control group, each MCL was subjected to mechanical testing. The stiffness, force and stress required to cause ligament elongation were less in the pie-crusting group (p < 0.05) compared to the control group, but were not statistically different than the traditional group. The pie-crusting group demonstrated a characteristic "stair-step" failure mode at the joint line, whereas the traditional group failed elastically at the tibial insertion. MCL pie-crusting is likely technique dependent since failure occurs within the ligament itself and further study is warranted.
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