Steven Claes

Steven Claes
AZ Sint-Elisabeth Herentals · Department of Orthopedics

MD, PhD

About

64
Publications
31,194
Reads
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3,345
Citations
Introduction
I am an orthopedic surgeon trained in the University Hospitals of Leuven and Ghent in Belgium, with a specific expertise in knee instabilities and sports injuries. I've performed extensive research on the anatomy, biomechanics and clinical implications surrounding the anterolateral ligament (ALL) of the knee, for which I attained a Doctoral Degree in Biomedical Sciences. Currently, my research revolves around ACL and ALL injuries.
Additional affiliations
January 2014 - April 2017
KU Leuven
Position
  • Consultant
December 2013 - present
Universitair Ziekenhuis Leuven, campus Pellenberg
Position
  • Consultant Orthopedic Surgeon - Knee & Sports
August 2008 - July 2009
Universitair Ziekenhuis Ghent
Position
  • Resident Orthopedic Surgery

Publications

Publications (64)
Article
Full-text available
In 1879, the French surgeon Segond described the existence of a 'pearly, resistant, fibrous band' at the anterolateral aspect of the human knee, attached to the eponymous Segond fracture. To date, the enigma surrounding this anatomical structure is reflected in confusing names such as '(mid-third) lateral capsular ligament', 'capsulo-osseous layer...
Article
Background The aim of this study was to give an overview of the accuracy of coronal limb alignment correction after high tibial osteotomy (HTO) for the arthritic varus knee by performing a systematic review of the literature. Methods The databases PubMed, MEDLINE and Cochrane Library were screened for relevant articles. Only prospective clinical s...
Article
Full-text available
Background: The anterolateral ligament has recently been identified as an important structure involved in rotational laxity after anterior cruciate ligament (ACL) rupture. Results of a combined ACL and anterolateral ligament (ALL) reconstruction technique have never been reported. Purpose: To report subjective and objective outcomes after combined...
Article
Purpose The purpose of this study was to investigate the relation of the Segond fracture with the anterolateral ligament (ALL) of the knee. Methods To identify the soft-tissue structure causative for the Segond fracture, a study was set up to compare anatomic details of the tibial insertion of the recently characterized ALL in cadaveric knees (n =...
Article
Full-text available
Surgical anterior cruciate ligament reconstruction using tendon grafts has become the standard to treat the functionally unstable anterior cruciate ligament-deficient knee. Although tendons clearly differ biologically from ligaments, multiple animal studies have shown that the implanted tendons indeed seem to remodel into a ligamentous "anterior cr...
Article
Background: Previous studies have shown a higher prevalence of meniscal and chondral lesions at the time of revision anterior cruciate ligament reconstruction (R-ACLR) compared with primary ACLR procedures. However, studies that follow the development of meniscal and chondral status through primary and subsequent R-ACLR are scarce. Purpose: To c...
Article
Background Anterior cruciate ligament reconstructed (ACLR) athletes show increased hamstrings activation and decreased knee flexion moments (KFMs) during single leg landing tasks at time of return-to-sport (RTS). Although these landing alterations seem protective in the short term, they might become undesirable if they persist after RTS. Therefore,...
Conference Paper
Full-text available
Background Evidence increasingly suggests that neuromuscular alterations in ACL reconstructed (ACLR) patients are rooted in neurocognitive and proprioceptive deficits. Objective The aim of this study was to reveal how neurocognitive and proprioceptive deficits determine neuromuscular control alterations seen in ACLR athletes. Design Cross-section...
Article
Mucoid degeneration of the anterior cruciate ligament: a little-known cause of deep knee pain Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known cause of deep atraumatic knee pain that is relatively frequent. Recent studies have reported a prevalence of 1,8-9,2% on MRI of the knee. Mucoid lesions consist of interstitial d...
Article
Background Patients suffering from bilateral combined medial osteoarthritis and varus alignment of the knee are eligible for bilateral high tibial osteotomy (HTO) in two-staged surgery. The impact of bilateral HTO surgery on rehabilitation and early outcomes have not yet been reported in the literature, even though these features are decisive in es...
Chapter
The establishment of precise anatomical landmarks of the anterolateral ligament (ALL) in 2013 has encouraged numerous publications about the true anatomy and biomechanics of the ALL. Despite initial controversy, the existence and importance of the anterolateral ligament are no longer under debate (Getgood et al., The anterolateral complex of the kn...
Article
Full-text available
Background: Evidence suggests that neuromuscular alterations in patients with an anterior cruciate ligament reconstruction (ACLR) are rooted in neurocognitive and proprioceptive deficits. The aim of this study was to assess neuromuscular control of athletes with ACLR under increased cognitive and environmental challenges. Research question: Do ath...
Article
Background Changes in knee joint line orientation (KJLO) resulting in excessive joint line obliquity are a well-known consequence of high tibial osteotomy (HTO) procedures and could lead to degenerative changes. The precise effect of the correction on final KJLO changes is poorly understood. The goal of this study was to identify radiographical par...
Article
Overuse injuries of the knee are a common cause of missed training and competition days in elite cyclists, however the underlying conditions causing this knee pain are not well defined. We conducted a diagnostic study, investigating a consecutive series of 53 high level cyclists with non-traumatic knee pain over a 14 month period. Demographic data...
Article
Purpose: To evaluate the magnetic resonance imaging (MRI) characteristics of Segond fractures, including the structures attached to the avulsed fragment, the integrity of anterolateral ligament (ALL) and iliotibial band (ITB) and fragment size and location. Methods: This is a retrospective cross-sectional study with MRI scans from 2016 to 2019 w...
Article
Introduction: Athletes returning to sport after anterior cruciate ligament reconstruction (ACLR) demonstrate prolonged changes in landing kinematics, kinetics and muscle activation, predisposing them for re-injury, knee osteoarthritis and/or knee instability. So far, researchers have been focusing on how kinematics and kinetics change in every joi...
Article
Purpose Painful and slow recovery are the presumed disadvantages after opening-wedge high tibial osteotomy (HTO) and play a role in favouring arthroplasty as treatment for moderate isolated medial knee arthritis. The primary study objective was to investigate the effect of press-fit structural impacted bone allograft with locking plate fixation on...
Article
Introduction: Fatigue has a negative impact on lower extremity neuromuscular and biomechanical control. Since ACLR athletes show already neuromuscular/biomechanical deficits in an unfatigued state, the negative impact of fatigue may magnify these deficits or help expose other deficits. So far this has only scarcely been assessed warranting further...
Article
Background: This level IV study describes a new one-stage procedure for revision ACL reconstruction in cases with extreme tunnel widening. Methods: Eight consecutively treated subjects requiring ACL revision and presenting with excessive tunnel widening (87.5% to 250% tunnel enlargement) were included in this study. The graft-tunnel mismatch was...
Article
Full-text available
We read with great interest the Editorial Commentary by Andy Williams, “The Anterolateral Ligament: The Emperor’s New Clothes?”
Article
The structure and function of the anterolateral complex (ALC) of the knee has created much controversy since the 're-discovery' of the anterolateral ligament (ALL) and its proposed role in aiding control of anterolateral rotatory laxity in the anterior cruciate ligament (ACL) injured knee. A group of surgeons and researchers prominent in the field...
Article
Full-text available
The structure and function of the anterolateral complex (ALC) of the knee has created much controversy since the 're-discovery' of the anterolateral ligament (ALL) and its proposed role in aiding control of anterolateral rotatory laxity in the anterior cruciate ligament (ACL) injured knee. A group of surgeons and researchers prominent in the field...
Article
Objectives: The aim of this study was to provide information about the mechanical properties of grafts used for knee ligament reconstructions and to compare those results with the mechanical properties of native knee ligaments. Methods: Eleven cadaveric knees were dissected for the semitendinosus, gracilis, iliotibial band (ITB), quadriceps and...
Article
Background: The aim of this study was to provide a characterization of the tensile properties of the medial collateral ligament (MCL), lateral collateral ligament (LCL), anterolateral ligament (ALL) and medial patellofemoral ligament (MPFL). Our hypothesis was that extra-articular knee ligaments are heterogeneous in nature and possess distinct mat...
Article
Purpose To characterize the tensile and histologic properties of the anterolateral ligament (ALL), inferior glenohumeral ligament (IGHL), and knee capsule. Methods Standardized samples of the ALL (n = 19), anterolateral knee capsule (n = 15), and IGHL (n = 13) were isolated from fresh-frozen human cadavers for uniaxial tensile testing to failure....
Chapter
Although the first mention of a ligament connecting the lateral femur with the anterolateral tibia was likely already made in the nineteenth century, this structure only gained global interest after its recent detailed characterisation. This chapter highlights the anatomical features of the knee’s anterolateral ligament (ALL), along with its functi...
Article
Persistent rotatory knee laxity is increasingly recognized as a common finding after anterior cruciate ligament (ACL) reconstruction. While the reasons behind rotator knee laxity are multifactorial, the impact of the anterolateral knee structures is significant. As such, substantial focus has been directed toward better understanding these structur...
Article
Full-text available
Purpose of this paper is to provide an overview of the latest research on the anterolateral ligament (ALL) and present the consensus of the ALL Expert Group on the anatomy, radiographic landmarks, biomechanics, clinical and radiographic diagnosis, lesion classification, surgical technique and clinical outcomes. A consensus on controversial subjects...
Article
Primary anterior cruciate ligament (ACL) reconstruction is a common orthopaedic procedure. A graft failure rate of 5% to 10% after primary ACL reconstruction has resulted in an increased need for revision ACL reconstruction. ACL reconstruction failure etiologies include trauma, technical errors, and biologic factors. Based on the current literature...
Article
Full-text available
Objectives: Recent publications have described significant variability in the femoral attachment and overall anatomy of the anterolateral ligament (ALL). Additionally, there is a paucity of data on its structural properties. The purpose of this comprehensive investigation was to provide quantitative data characterizing the anatomic and radiographic...
Article
Full-text available
Recent publications have described significant variability in the femoral attachment and overall anatomy of the anterolateral ligament (ALL). Additionally, there is a paucity of data describing its structural properties. Quantitative data characterizing the anatomic and radiographic locations and the structural properties of the ALL may be used to...
Article
The goal of this study was to evaluate postural stability during the transition from double-leg stance (DLS) to single-leg stance (SLS) in anterior cruciate ligament reconstructed (ACLR) (n=20) and non-injured control subjects (n=20). All ACLR subjects had fully returned to their pre-injury sport participation. Both groups were similar for age, gen...
Article
Background: An anterior cruciate ligament injury may lead to deteriorations in postural stability. The goal of this study was to evaluate postural stability during the transition from double-leg stance to single-leg stance of both legs in anterior cruciate ligament injured subjects and non-injured control subjects with a standardized methodology....
Article
Background: Although anterior knee pain is extremely common in high-level road cyclists, the exact etiology still remains unclear. Methods: A group of 28 professional male elite cyclists diagnosed with Prepatellar Friction Syndrome (PPFS) were retrospectively reviewed with specific attention for the typical history, clinical findings and treatment...
Article
Full-text available
Anterior cruciate ligament reconstruction is performed as an outpatient procedure in selected cases. Whether it can be safely performed on a routine basis in day clinic remains unclear. Our hypothesis was that routinely performing outpatient anterior cruciate ligament reconstruction would be equally safe as compared to inpatient procedures. A cohor...
Article
Deficits in neuromuscular control are believed to increase re-injury risk after anterior cruciate ligament reconstruction (ACLR). Previous studies mainly focused on muscles at the operated knee, less on muscles around other joints of the operated and non-operated leg. To evaluate lower extremity muscle onset times during the transition from double-...
Article
Despite recent advances in rehabilitation and secondary prevention strategies after anterior cruciate ligament reconstruction (ACLR), re-injury rates remain high and long-term outcomes are often disappointing. Deficits in postural stability are shown to be important. To evaluate postural stability during the transition from double-leg stance to sin...
Chapter
The occurrence of osteoarthritis (OA) is often thought of as a near-inevitable long-term consequence of ACL injury, with prevalences of 50–80 % reported a decade after the initial trauma [18, 36]. In this view, ACL tears are often quoted as being responsible for a large percentage of the “young patients with old knees,” [18, 37] irrespective of the...
Article
Full-text available
The purpose of this study was to identify the newly described anterolateral ligament of the human knee on magnetic resonance imaging and to describe its eventual radiological abnormalities in anterior cruciate ligament-injured subjects. A retrospective cohort study on a series of consecutive subjects undergoing anterior cruciate ligament reconstruc...
Article
Background Although characterized by a relatively high injury rate, soccer is the world’s most popular sport. In Belgium, the national Royal Belgian Football Association involves about 420,000 licensed players, whose injury reports are collected in a nationwide registry. Over a period of 10 years, the association has introduced the Fédération Inter...
Article
Full-text available
The aim of this study was to assess the incidence of intraoperative failure of the FasT-fix (Smith & Nephew, Andover, USA) device for all-inside meniscal repair and to investigate any underlying factors. Searching retrospectively the hospital databases and patient files, we collected 78 cases, totalling 61 successes and 17 failures. Of a total of 1...
Article
The objective of this study was to validate a new technique to safely obtain core biopsy specimens of the anterior cruciate ligament (ACL) without jeopardizing the ACL's biomechanical properties. Eleven pairs of fresh porcine femur-ACL-tibia complexes were tested in a loading frame. The ACL of one knee was biopsied using a spring-loaded core biopsy...
Article
Full-text available
An association between lateral patellar dislocation (LPD) and medial collateral ligament injury (MCL) has recently been demonstrated on MRI. The same valgus injury that disrupts the femoral MCL insertion can also cause a simultaneous MPFL tear at its femoral insertion, due to the close anatomical relationship of both ligamentous structures. Valgus...
Article
Full-text available
In an epidemiological study we assessed the evolution in the incidence and possible risk factors of knee injuries, especially anterior cruciate ligament (ACL) injuries, in Belgian soccer over one decade. Two soccer seasons (1999-2000 and 2009-2010) were compared and 56,364 injury reports registered by the KBVB-URBSFA were retrieved. Knee injuries t...
Article
Purpose: The purpose of this study was to investigate the relation of the Segond fracture with the anterolateral ligament (ALL) of the knee. Methods: To identify the soft-tissue structure causative for the Segond fracture, a study was set up to compare anatomic details of the tibial insertion of the recently characterized ALL in cadaveric knees (n...
Article
Full-text available
Although articulated cement spacers are frequently used in a staged approach of an infected total knee arthroplasty (TKA), no data are available on the incidence and type of spacer-related problems in these patients. A retrospective analysis of 154 patients who underwent a two-stage revision procedure for an infected TKA was performed. All patients...
Article
Full-text available
Purpose: Restoration of correct alignment is one of the main objectives of total knee arthroplasty (TKA). However, the influence of residual malalignment on clinical and functional outcomes is currently uncertain. This study was therefore undertaken to ascertain its influence in patients undergoing TKA for varus osteoarthritis of the knee. Method...
Article
Full-text available
Purpose Although the occurrence of early osteoarthritis (OA) is commonly associated with a history of anterior cruciate ligament (ACL) reconstruction, its exact prevalence in these patients remains unknown. The goal of this study was to review the current literature on long-term radiographic outcome after autologous ACL reconstruction and subsequen...
Article
Full-text available
The effect of double-bundle ACL reconstruction on knee kinematics has recently been studied by several authors under controlled laboratory conditions however little evidence has been derived from dynamic in vivo evaluations. This study hypothesized that tibial rotation during pivoting motor tasks would be better restored after double-bundle ACL rec...
Article
Heterotopic ossification is the abnormal formation of bone within extraskeletal soft tissues. Classically, the development of heterotopic ossification is usually associated with many predisposing factors including local trauma, neurological injury (both to the spinal cord and the brain), burns and major joint surgery, most frequently with total hip...
Article
Full-text available
Heterotopic ossification is the abnormal formation of bone within extraskeletal soft tissues. Classically, the development of heterotopic ossification is usually associated with many predisposing factors including local trauma, neurological injury (both to the spinal cord and the brain), burns and major joint surgery, most frequently with total hip...

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