Document Detail


Surgical technique: does mini-invasive medial collateral ligament and posterior oblique ligament repair restore knee stability in combined chronic medial and ACL injuries?
MedLine Citation:
PMID:  21842298     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Residual laxity remains after ACL reconstruction in patients with combined chronic ACL and medial instability. The question arises whether to correct medial capsular and ligament injuries when Grade II and III medial laxity is present.
DESCRIPTION OF TECHNIQUE: We developed a mini-invasive medial ligament plasty to repair the medial collateral ligament to correct residual medial valgus and rotatory laxity after ACL reconstruction.
PATIENTS AND METHODS: We prospectively followed 36 patients with an ACL deficiency combined with chronic Grade II or III valgus and rotatory medial instability. The mean age was 37 years (range, 15-70 years). For all patients, we obtained preoperative and postoperative Knee Injury and Osteoarthritis Outcome, International Knee Documentation Committee, Lysholm, and Tegner Activity Level Scores. The minimum followup was 2 years (median, 3 years; range, 2-7 years).
RESULTS: The mean subjective International Knee Documentation Committee score improved from 36 preoperatively to 94 at the last followup. While all patients had an International Knee Documentation Committee score of Grade C or D preoperatively, no patient did postoperatively. The mean Knee Injury and Osteoarthritis Outcome Score improved from 45 preoperatively to 93 postoperatively. Valgus and external rotatory tests were negative in all patients. The mean Tegner activity level decreased from 7 preinjury to 6 postoperatively, and the mean Lysholm score improved from 40 preoperatively to 93 at last followup.
CONCLUSIONS: This simple technique restored medial stability and knee function to normal or nearly normal in all patients.
LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Authors:
Gian Luigi Canata; Alfredo Chiey; Tommaso Leoni
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  470     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-02     Completed Date:  2012-04-30     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  791-7     Citation Subset:  AIM; IM    
Affiliation:
Centre of Sports Traumatology, Koelliker Hospital, Corso Duca degli Abruzzi 30, 10129 Turin, Italy. canata@ortosport.it
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anterior Cruciate Ligament Reconstruction*
Female
Humans
Joint Instability / surgery*
Knee Injuries / surgery*
Ligaments, Articular / surgery*
Male
Medial Collateral Ligament, Knee / surgery
Middle Aged
Orthopedic Procedures / methods*,  rehabilitation
Surgical Procedures, Minimally Invasive
Suture Techniques
Young Adult
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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