Current functional status of patients with surgical reconstruction of KD I posteromedial injuries of the knee injuries: Case series
DOI:
https://doi.org/10.1016/j.rccot.2017.07.002Keywords:
dislocated knee, multiple ligament injury knee, posterior-medial cornerAbstract
Background: To evaluate current functional results in patients operated by medial corner injury of the knee KD I we compared the results obtained in patients with anteromedial involvement (LCA) with those of posteromedial involvement (LCP)
Materials & methods: Case series study where patients were assessed with posteromedial corner injuries knees KD I operated on between 2008 and 2013. The current clinical and functional assessment was performed with the IKDC, Lysholm, Tegner and EVA scales, and mobility and stability tests.
Results: Nine patients were included with a 2 1/2 years follow-up, the average age was 36 years. There were 6 cases of traffic accidents, 4 LCP injuries and 5 LCA injuries. During the clinical evaluation, we found 7 asymptomatic patients during daily activities, half of patients get more than 70 and 82 points on IKDC and Lysholm scales respectively, with acceptable functionality and decreased physical activity (Tegner from 7 to 5). All had some degree of residual anteroposterior instability, in 4 cases mild medial instability and limited flexion 2.
Discussion: The surgical management of medial injury with ACL or LCP lesions restores valgus stability with persistent mild anterior-posterior and rotational instability.
Evidence leve: IV.
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References
Stannard J. Medial and posteromedial instability of the knee: Evaluation, treatment, and results. Sports Med Arthrosc. 2010;18:263-8. https://doi.org/10.1097/JSA.0b013e3181eaf713
Papalia R, Osti L, Del Buono A, Denaro V, Maffulli N. Management of combined ACL-MCL tears: a systematic review. Br Med Bull. 2010;93:201-15. https://doi.org/10.1093/bmb/ldp044
Yoshiya S, Kuroda R, Mizuno K, Yamamoto T, Kurosaka M. Collateral ligament reconstruction using autogenous hamstring tendons: Technique and results in initial cases. Am J Sports Med. 2005;33:1380-5. https://doi.org/10.1177/0363546504273487
Marchant MJ, Tibor L, Sekiya J, Hardaker WJ, Garrett WJ, Taylor D. Management of medial-sided knee injuries, part 1: medial collateral ligament. Am J Sports Med. 2011;39:1102-13. https://doi.org/10.1177/0363546510385999
Jacobson K, Chi F. Evaluation and treatment of medial collateral ligament and medial-sided injuries of the knee. Sports Med Arthrosc Rev. 2006;14:58-66. https://doi.org/10.1097/01.jsa.0000212305.47323.58
Lonergan K, Taylor A. Medial collateral ligament injuries of the knee: An evolution of surgical reconstruction. Techniques in Knee Surgery. 2002;1:137-45. https://doi.org/10.1097/00132588-200212000-00008
House C, Connell D, Saifuddin A. Posteromedial corner injuries of the knee. Clin Radiol. 2007;62:539-46. https://doi.org/10.1016/j.crad.2006.11.024
Hubert M, Stannard J. Surgical treatment of acute and chronic anterior and posterior cruciate ligament and medial-side injuries of the knee. Sports Med Arthrosc Rev. 2011;19:104-9. https://doi.org/10.1097/JSA.0b013e3182191874
De los Ríos A. Luxación de rodilla, Tratamiento quirúrgico en casos agudos. RCCOT. 2005;19:34-43.
Tibor L, Marchant MJ, Taylor D, Hardaker WJ, Garrett WJ, Sekiya J. Management of medial-sided knee injuries, part 2: Posteromedial corner. Am J Sports Med. 2011;39:1332-40. https://doi.org/10.1177/0363546510387765
Giannotti B, Rudy T, Graziano J. The non-surgical management of isolated medial collateral ligament injuries of the knee. Sports Med Arthrosc Rev. 2006;14:74-7. https://doi.org/10.1097/01.jsa.0000212307.54947.e4
Grant J, Tannenbaum E, Miller B, Bedi A. Treatment of combined complete tears of the anterior cruciate and medial collateral ligaments. Arthroscopy. 2012;28:110-22. https://doi.org/10.1016/j.arthro.2011.08.293
Fanelli G, Harris J. Surgical treatment of acute medial collateral ligament and posteromedial corner injuries of the knee. Sports Med Arthrosc Rev. 2006;14:78-83. https://doi.org/10.1097/01.jsa.0000212301.80496.dc
Laprade R, Wijdicks C. Surgical technique development of an anatomic medial knee reconstruction. Clin Orthop Relat Res. 2012;470:806-14. https://doi.org/10.1007/s11999-011-2061-1
Derscheid GL, Garrick JG. Medial collateral ligament injuries in football: Nonoperative management of grade I and grade II sprains. Am J Sports Med. 1981;9:365-8. https://doi.org/10.1177/036354658100900605
Lundberg M, Messner K. Long-term prognosis of isolated partial medial collateral ligament ruptures: A ten-year clinical and radiographic evaluation of a prospectively obser ved group of patients. Am J Sports Med. 1996;24:160-3. https://doi.org/10.1177/036354659602400207
Indelicato PA, Hermansdorfer J, Huegel M. Nonoperative management of complete tears of the medial collateral ligament of the knee in intercollegiate football players. Clin Orthop Relat Res. 1990;(256):174-7. https://doi.org/10.1097/00003086-199007000-00025
Kannus P. Long-term results of conservatively treated medial collateral ligament injuries of the knee joint. Clin Orthop Relat Res. 1998;(226):103-12. https://doi.org/10.1097/00003086-198801000-00015
Reider B, Sathy MR, Talkington J, Blyznak N, Kollias S. Treatment of isolated medial collateral ligament injuries in athletes with early functional rehabilitation. A five-year follow-up study. Am J Sports Med. 1994;22:470-7. https://doi.org/10.1177/036354659402200406
Hughston JC, Barrett GR. Acute anteromedial rotatory instability, Long-term results of surgical repair. J Bone Joint Surg Am. 1983;65:145-53. https://doi.org/10.2106/00004623-198365020-00002
Hughston JC. The importance of the posterior oblique ligament in repairs of acute tears of the medial ligaments in knees with and without an associated rupture of the anterior cruciate ligament, Results of long-term follow-up. J Bone Joint Surg Am. 1994;76:1328-44. https://doi.org/10.2106/00004623-199409000-00008
Kannus P. Long-term results of conservatively treated medial collateral ligament injuries of the knee joint. Clin Orthop Relat Res. 1988:103-12. https://doi.org/10.1097/00003086-198801000-00015
Bonasia DE, Bruzzone M, Dettoni F, Marmotti A, Blonna D, Castoldi F, et al. Gasparetto F, D'Elicio D, Collo G, Rossi R. Treatment of medial and posteromedial knee instability: indications, techniques, and review of the results. Iowa Orthop J. 2012;32:173-83.
Bauer KL, Stannard JP. Surgical approach to the posteromedial corner: indications, technique, outcomes. Curr Rev Musculoskelet Med. 2013;6:124-31. https://doi.org/10.1007/s12178-013-9161-3
Stannard JP, Black BS, Azbell C, Volgas DA. Posteromedial corner injury in knee dislocations. J Knee Surg. 2012;25:429-34. https://doi.org/10.1055/s-0032-1322605
Wijdicks CA, Griffith CJ, Johansen S, Engebretsen L, LaPrade RF. Injuries to the medial collateral ligament and associated medial structures of the knee current concepts review. J Bone Joint Surg Am. 2010;92:1266-80. https://doi.org/10.2106/JBJS.I.01229
Kuroda R, Muratsu H, Harada T, Hino T, Takayama H, Miwa M, Sakai H, et al. Avulsion fracture of the posterior oblique ligament associated with acute tear of the medial collateral ligament. Arthroscopy. 2003;19:E18. https://doi.org/10.1053/jars.2003.50069
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