Surgical Treatment of Acute Grade III Medial Collateral Ligament Injury Combined With Anterior Cruciate Ligament Injury: Anatomic Ligament Repair Versus Triangular Ligament Reconstruction
| Autor: | Jiangtao Dong, Shi Jun Gao, Yingze Zhang, Xiao Zuo Zheng, Xiao-qian Men, Junjun Zhu, Jin Bao Gao, Fei Wang, Xiao-feng Wang, Garth N. Walker, Bai-cheng Chen |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Joint Instability Male medicine.medical_specialty Anterior cruciate ligament reconstruction Radiography medicine.medical_treatment Anterior cruciate ligament Medial Collateral Ligament Knee Knee Injuries law.invention Young Adult Triangular Ligament Randomized controlled trial Ligament repair law medicine Humans Orthopedics and Sports Medicine Anterior Cruciate Ligament Range of Motion Articular Aged Medial collateral ligament Anterior Cruciate Ligament Reconstruction business.industry Anterior Cruciate Ligament Injuries Middle Aged Plastic Surgery Procedures Surgery medicine.anatomical_structure Treatment Outcome Female business Range of motion |
| Zdroj: | Arthroscopy : the journal of arthroscopicrelated surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 31(6) |
| ISSN: | 1526-3231 |
| Popis: | The purpose of this study was to evaluate the clinical results of medial collateral ligament (MCL) anatomic ligament repair (ALR) and triangular ligament reconstruction (TLR) in treating acute grade III MCL injury with respect to imaging and functional results.Between January 2009 and October 2011, a total of 69 patients with an acute grade III MCL tear combined with an anterior cruciate ligament tear were divided into 2 groups: those who underwent ALR and those who underwent TLR. Single-bundle anterior cruciate ligament reconstruction was also performed in all patients. A radiographic stress-position imaging test was performed to evaluate excessive medial opening of the knee. In addition, the Slocum test was carried out to assess anteromedial rotatory instability before surgery and at follow-up. The subjective symptoms and functional outcomes were evaluated preoperatively and postoperatively with International Knee Documentation Committee (IKDC) assessment.Sixty-four patients with a mean follow-up period of 34 months were included in the final analysis. The measurement results for medial opening at the last follow-up appointment decreased significantly from the pretreatment measurements and fell within the normal range, without a statistically significant difference between the 2 groups (P.05). The overall incidence of anteromedial rotatory instability was reduced to 21.9% compared with 62.5% preoperatively. However, the incidence of anteromedial rotatory instability in the TLR group (9.4%) decreased significantly compared with that in the ALR group (34.4%) (P.05). All patients' IKDC subjective scores significantly improved after surgery. No statistically significant difference was found between the 2 groups at the last follow-up (P.05). The comparison of IKDC extension and flexion deficit scores between the 2 groups showed no significant differences. Eleven patients in the ALR group and 4 in the TLR group complained of medial knee pain. The comparison between the 2 groups showed no significant difference (P.05).The clinical outcomes of this study showed that no major difference existed in the ALR and TLR groups based on IKDC scores and medial opening evaluations in the short-term. However, TLR offered better rotatory stability than ALR at final follow-up.Level II, lesser-quality randomized controlled trial. |
| Databáze: | OpenAIRE |
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