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Anatomical reconstruction of the medial collateral ligament and posteromedial corner of the knee in patients with chronic medial collateral ligament instability.
Am J Sports Med. 2009 Jun; 37(6):1116-22.AJ

Abstract

BACKGROUND

In cases of multiple ligament injury or severe medial collateral ligament (MCL) lesion, nonoperative treatment of the MCL lesion may lead to chronic valgus instability or rotatory instability.

HYPOTHESIS

In a retrospective case series after isolated and combined MCL reconstructions using a novel MCL reconstruction technique that addresses both the MCL and the posteromedial corner, an acceptable clinical outcome is expected 2 years after MCL reconstruction.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

From July 2002 to December 2005, 61 patients with grade 3 or 4 medial instability were treated with MCL reconstruction. Median age was 33 years (range, 14-62). Thirteen underwent isolated MCL reconstructions, 34 had combined MCL and anterior cruciate ligament (ACL) reconstruction, and 14 had multiple ligament reconstructions. All patients had reconstruction of the medial collateral and the posteromedial complex using ipsilateral semitendinosus autografts. Fifty patients were available for follow-up more than 24 months postoperatively and were examined by an independent observer using objective International Knee Documentation Committee (IKDC) measures and subjective Knee Injury and Osteoarthritis Outcome Score (KOOS).

RESULTS

At follow-up, medial stability according to the IKDC score showed 98% normal or nearly normal (grade A or B), and for overall IKDC score, patients improved from 5% with grade A or B preoperatively to 74% with grade A or B at follow-up. There were 91% who were satisfied or very satisfied with the result; 88% would go through surgery again. The KOOS improved primarily for sports and quality of life subscales with approximately 10-point improvements.

CONCLUSION

Acceptable clinical results with the MCL reconstruction technique were achieved in patients suffering from chronic valgus instability.

Authors+Show Affiliations

Division of Sports Trauma, Aarhus Sygehus, Tage Hansens Gade 2, Aarhus DK 8000, Denmark. martinlind@dadlnet.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19336612

Citation

Lind, Martin, et al. "Anatomical Reconstruction of the Medial Collateral Ligament and Posteromedial Corner of the Knee in Patients With Chronic Medial Collateral Ligament Instability." The American Journal of Sports Medicine, vol. 37, no. 6, 2009, pp. 1116-22.
Lind M, Jakobsen BW, Lund B, et al. Anatomical reconstruction of the medial collateral ligament and posteromedial corner of the knee in patients with chronic medial collateral ligament instability. Am J Sports Med. 2009;37(6):1116-22.
Lind, M., Jakobsen, B. W., Lund, B., Hansen, M. S., Abdallah, O., & Christiansen, S. E. (2009). Anatomical reconstruction of the medial collateral ligament and posteromedial corner of the knee in patients with chronic medial collateral ligament instability. The American Journal of Sports Medicine, 37(6), 1116-22. https://doi.org/10.1177/0363546509332498
Lind M, et al. Anatomical Reconstruction of the Medial Collateral Ligament and Posteromedial Corner of the Knee in Patients With Chronic Medial Collateral Ligament Instability. Am J Sports Med. 2009;37(6):1116-22. PubMed PMID: 19336612.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anatomical reconstruction of the medial collateral ligament and posteromedial corner of the knee in patients with chronic medial collateral ligament instability. AU - Lind,Martin, AU - Jakobsen,Bent Wulff, AU - Lund,Bent, AU - Hansen,Mogens Strange, AU - Abdallah,Ossama, AU - Christiansen,Svend Erik, Y1 - 2009/03/31/ PY - 2009/4/2/entrez PY - 2009/4/2/pubmed PY - 2009/8/28/medline SP - 1116 EP - 22 JF - The American journal of sports medicine JO - Am J Sports Med VL - 37 IS - 6 N2 - BACKGROUND: In cases of multiple ligament injury or severe medial collateral ligament (MCL) lesion, nonoperative treatment of the MCL lesion may lead to chronic valgus instability or rotatory instability. HYPOTHESIS: In a retrospective case series after isolated and combined MCL reconstructions using a novel MCL reconstruction technique that addresses both the MCL and the posteromedial corner, an acceptable clinical outcome is expected 2 years after MCL reconstruction. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: From July 2002 to December 2005, 61 patients with grade 3 or 4 medial instability were treated with MCL reconstruction. Median age was 33 years (range, 14-62). Thirteen underwent isolated MCL reconstructions, 34 had combined MCL and anterior cruciate ligament (ACL) reconstruction, and 14 had multiple ligament reconstructions. All patients had reconstruction of the medial collateral and the posteromedial complex using ipsilateral semitendinosus autografts. Fifty patients were available for follow-up more than 24 months postoperatively and were examined by an independent observer using objective International Knee Documentation Committee (IKDC) measures and subjective Knee Injury and Osteoarthritis Outcome Score (KOOS). RESULTS: At follow-up, medial stability according to the IKDC score showed 98% normal or nearly normal (grade A or B), and for overall IKDC score, patients improved from 5% with grade A or B preoperatively to 74% with grade A or B at follow-up. There were 91% who were satisfied or very satisfied with the result; 88% would go through surgery again. The KOOS improved primarily for sports and quality of life subscales with approximately 10-point improvements. CONCLUSION: Acceptable clinical results with the MCL reconstruction technique were achieved in patients suffering from chronic valgus instability. SN - 1552-3365 UR - https://www.unboundmedicine.com/medline/citation/19336612/Anatomical_reconstruction_of_the_medial_collateral_ligament_and_posteromedial_corner_of_the_knee_in_patients_with_chronic_medial_collateral_ligament_instability_ L2 - http://journals.sagepub.com/doi/full/10.1177/0363546509332498?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -