Medial collateral ligament healing one year after a concurrent medial collateral ligament and anterior cruciate ligament injury: An interdisciplinary study in rabbits

Background: The appropriate management of acute grade III medial collateral ligament injury when it is combined with a torn anterior cruciate ligament has not been determined. Hypothesis: Magnetic resonance imaging grading of grade III medial collateral ligament injury in patients who also have anterior cruciate ligament injury correlates with the outcome of their nonoperative treatment. Study Design: Prospective cohort study. Methods: Seventeen patients were first treated nonoperatively with bracing. Eleven patients with restored valgus stability received anterior cruciate ligament reconstruction only, and six with residual valgus laxity also received medial collateral ligament surgery. Results: Magnetic resonance imaging depicted complete disruption of the superficial layer of the medial collateral ligament in all 17 patients and disruption of the deep layer in 14. Restoration of valgus stability was significantly correlated with the location of superficial fiber damage. Damage was evident over the whole length of the superficial layer in five patients, and all five patients had residual valgus laxity despite bracing. Both groups had good-to-excellent results 5 years later. Conclusions: Location of injury in the superficial layer may be useful in predicting the outcome of nonoperative treatment for acute grade III medial collateral ligament lesions combined with anterior cruciate ligament injury.

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Return to Sports after Acute Simultaneous Reconstruction of Anterior Cruciate Ligament Injury and Grade III Medial Collateral Ligament Injury

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967117s00031 ◽

2017 ◽

Vol 5 (1_suppl) ◽

pp. 2325967117S0003

Author(s):

Agustin Bertona ◽

Juan Pablo Zicaro ◽

Juan Manuel Gonzalez Viescas ◽

Nicolas Atala ◽

Carlos Yacuzzi ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Medial Collateral Ligament ◽

Cruciate Ligament ◽

Return To Sport ◽

Ligament Injury ◽

Collateral Ligament ◽

Simultaneous Reconstruction ◽

Anterior Cruciate ◽

Grade Iii

Objectives: Combined Anterior Cruciate Ligament (ACL) injury and Medial Collateral Ligament (MCL) injury account for 20% of knee ligament lesions. Conservative treatment of MCL and surgical ACL reconstruction are generally recommended. Significant medial instability after non-surgical management of MCL can lead to ACL reconstruction failure. The optimal management for athletes with combined ACL-MCL injuries remains controversial. The purpose of this study was to analyze the functional and clinical evolution of patients who underwent combined ACL-MCL surgery and their return-to-sport level with minimum 2-years follow-up. Methods: A total of 20 athletes with acute simultaneous ACL/Grade III MCL reconstructions were treated between March 2006 and January 2014. The minimum follow-up time was 24 months. Subjective functional results (IKDC, Lysholm), range of motion, anterior-medial and rotational stability (Lachmann, Pivot Shift, valgus stress) were evaluated. The ability to return to sport (Tegner) and the level achieved was recorded. Results: All patients significantly improved functional scores and stability tests. The mean subjective IKDC score improved from 37.7 ± 12.9 (range 21-69) preoperatively to 88.21 ± 4.47 (range 80-96) postoperatively (P <0.05). The average Lysholm score was 40.44 ± 10.58 (range 27-65) preoperatively and 90.83 ± 3.38 (range 84-95) postoperatively (P <0.05). Valgus and sagittal laxity was not observed (IKDC A 92% B 8%) at final follow-up. All patients had normal/nearly normal (IKDC A or B) mobility. All patients returned to sports; 90% reached the level they had prior to the ligamentous injury. Of all competitive athletes, 66% achieved the same level of sport. Conclusion: In athletes with acute ACL-Grade III MCL lesions, an early simultaneous reconstruction can significantly improve the medial and sagittal stability of the knee. This procedure resulted in excellent functional outcomes, with return to the same level of sports in the majority of patients at short-term follow-up.

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Psychological Rehabilitation From Anterior Cruciate Ligament–Medial Collateral Ligament Reconstructive Surgery: A Case Study

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738109357173 ◽

2009 ◽

Vol 2 (1) ◽

pp. 73-77 ◽

Cited By ~ 15

Author(s):

Siobhain McArdle

Keyword(s):

Anterior Cruciate Ligament ◽

Medial Collateral Ligament ◽

Cruciate Ligament ◽

Traumatic Injury ◽

Situational Factors ◽

Ligament Injury ◽

Collateral Ligament ◽

Retrospective Case ◽

Psychological Response ◽

Anterior Cruciate

Background: Research has shown that some of the more common psychological responses to injury (ie, depression, anger, anxiety) are amplified in cases of traumatic injury. Hypothesis/Purpose: An 18-year-old male scholarship soccer player who, owing to a perceived deliberate injurious tackle by an opposition player, tore the medial collateral ligament and anterior cruciate ligament of his right knee. A psychological case perspective is presented. Study Design: Retrospective case report. Results: Various personal and situational factors can compound negative psychological response to injury. A number of extreme responses are explored, including posttraumatic stress, depression, and fear of reinjury. Conclusions: Practitioners should be willing and able to facilitate referral in the instance of more extreme psychological response to anterior cruciate ligament injury.

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