Primary reconstruction of the medial collateral ligament in combined injury of the medial collateral and anterior cruciate ligaments

1998 ◽  
Vol 6 (2) ◽  
pp. 103-106 ◽  
Author(s):  
J. P. M. Frölke ◽  
Jacques Oskam ◽  
Pieter A. M. Vierhout
Keyword(s):  
Medial Collateral Ligament ◽  
Cruciate Ligaments ◽  
Primary Reconstruction ◽  
Collateral Ligament ◽  
Anterior Cruciate Ligaments ◽  
Combined Injury ◽  
Anterior Cruciate

Does Nitric Oxide Help Explain the Differential Healing Capacity of the Anterior Cruciate, Posterior Cruciate, and Medial Collateral Ligaments?

2000 ◽  
Vol 28 (2) ◽  
pp. 176-182 ◽  
Author(s):  
Cao Min ◽  
Maja Stefanovic-Racic ◽  
Helga I. Georgescu ◽  
Freddie H. Fu ◽  
Christopher H. Evans
Keyword(s):  
Nitric Oxide ◽  
Anterior Cruciate Ligament ◽  
Posterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Collagen Synthesis ◽  
Cruciate Ligament ◽  
Cruciate Ligaments ◽  
Matrix Synthesis ◽  
Collateral Ligament ◽  
Anterior Cruciate

This study compared the ability of rabbit medial collateral ligament, posterior cruciate ligament, and anterior cruciate ligament tissue to synthesize nitric oxide, and determined its effects on matrix synthesis, an important component of ligament repair. It is not known whether ligament cells can produce nitric oxide and, if so, whether it influences healing of ligament injuries. The anterior cruciate and posterior cruciate ligament tissue produced large amounts of nitric oxide in response to the inflammatory cytokine interleukin-1. Medial collateral ligament, in contrast, produced only modest amounts of nitric oxide. Furthermore, anterior cruciate ligament and, to some degree, posterior cruciate ligament synthesized nitric oxide spontaneously in culture, whereas medial collateral ligament never did so. When nitric oxide was supplied to these tissues, it strongly inhibited collagen synthesis by the two cruciate ligaments, but had little effect on collagen synthesis by the medial collateral ligament. Endogenously synthesized nitric oxide was also able to inhibit collagen synthesis as well as proteoglycan synthesis by the two cruciate ligaments, but had little effect on matrix synthesis by the medial collateral ligament. We propose a novel hypothesis, based on nitric oxide production and matrix synthesis, that may help explain why the two cruciate ligaments have such limited healing capacity compared with the medial collateral ligament.

scholarly journals Clinical and Arthroscopic Findings of Acute Anterior Cruciate Ligament Tears of the Knee

1995 ◽  
Vol 2 (2) ◽  
pp. 107-112 ◽  
Author(s):  
Kenji Shirakura ◽  
Masanori Terauchi ◽  
Naoki Fukasawa ◽  
Masashi Kimura ◽  
Takachika Shimizu
Keyword(s):  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Collateral Ligament ◽  
Initial Examination ◽  
Full Extension ◽  
Acl Injuries ◽  
Anterior Cruciate Ligaments ◽  
Medial Side ◽  
Arthroscopic Findings ◽  
Anterior Cruciate

Clinical, arthrographic, and arthroscopic findings in 53 patients with acutely torn anterior cruciate ligaments (ACLs) were documented. Arthroscopy and instability tests under anesthesia were performed on all patients within 2 weeks after the initial injury. Twenty-three patients complained of extension blocks, and localized tenderness on the medial side was revealed in 26 patients at the initial examination. Aspiration from joints exhibited hemarthrosis in 52 patients. Arthroscopy revealed ACL ruptures in all patients. Four Segond's fractures, 26 meniscus tears (8 medial and 18 lateral), 1 osteochondral fracture, and 19 medial collateral ligament ruptures were revealed. Arthroscopy detected only 1 of the 5 ruptures of the posteromedial corner of the medial meniscus, which were noted on arthrography. Three ACL stumps were protruding among the femorotibial joint, which seemed to be restricting full extension. Statistical analysis showed that tenderness on the medial side was not revealed more frequently in knees with medial collateral ligament injuries than in the others. The volume of aspirated fluids in knees with no leakage in arthrography significantly increased over those with leakages (p < 0.05). Diagnosis of ACL injuries should be completed by clinical, arthrographic, and arthroscopic examinations.

Evaluation of knee-joint cartilage and menisci ten years after isolated and combined ruptures of the medial collateral ligament

1997 ◽  
Vol 38 (1) ◽  
pp. 151-157 ◽  
Author(s):  
M. Lundberg ◽  
K.-Å Thuomas ◽  
K. Messner
Keyword(s):  
Mr Imaging ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
Joint Fluid ◽  
Collateral Ligament ◽  
Combined Injury ◽  
Isolated Injury ◽  
Anterior Cruciate ◽  
Almost All

Purpose: To compare radiography, MR imaging, and chemical analysis in posttraumatic knees. Material and Methods: Ten matched pairs with either isolated partial rupture of the medial collateral ligament or combined medial collateral ligament/anterior cruciate ligament rupture were compared with matched controls 10 years after trauma. Weight-bearing radiographs and MR examinations were compared with proteoglycan fragment concentrations in the joint fluid. Results: The chemical analyses were similar in both trauma groups. The radiographs showed mild signs of arthrosis in half the patients with combined injury. MR images showed almost all injuried knees to have degenerative changes of various degrees in the cartilage and menisci. More frequent and more advanced changes were found after combined injury than after isolated injury (p <0.01). There were no changes in the controls. Conclusion: MR imaging is the best method for detecting and differentiating early posttraumatic knee arthrosis.

scholarly journals The novel epiligament theory: differences in healing failure between the medial collateral and anterior cruciate ligaments

2022 ◽  
Vol 9 (1) ◽  
Author(s):  
Georgi P. Georgiev ◽  
Manasi Telang ◽  
Boycho Landzhov ◽  
Łukasz Olewnik ◽  
Svetoslav A. Slavchev ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Healing Process ◽  
The Novel ◽  
Collateral Ligament ◽  
Knee Ligament ◽  
Anterior Cruciate Ligaments ◽  
Ligament Healing ◽  
Anterior Cruciate

AbstractAccording to current literature, 90% of knee ligament injuries involve the medial collateral ligament or the anterior cruciate ligament. In contrast to the medial collateral ligament, which regenerates relatively well, the anterior cruciate ligament demonstrates compromised healing. In the past, there were numerous studies in animal models that examined the healing process of these ligaments, and different explanations were established. Although the healing of these ligaments has been largely investigated and different theories exist, unanswered questions persist.Therefore, the aim of this article is 1) to review the different historical aspects of healing of the medial collateral ligament and present the theories for healing failure of the anterior cruciate ligament; 2) to examine the novel epiligament theory explaining the medial collateral ligament healing process and failure of anterior cruciate ligament healing; and 3) to discuss why the enveloping tissue microstructure of the aforementioned ligaments needs to be examined in future studies.We believe that knowledge of the novel epiligament theory will lead to a better understanding of the normal healing process for implementing optimal treatments, as well as a more holistic explanation for anterior cruciate ligament healing failure.

Function of the crocodilian anterior cruciate ligaments

2021 ◽  
Author(s):  
Daisuke Suzuki ◽  
Satoshi Yamakawa ◽  
Masaya Iijima ◽  
Hiromichi Fujie
Keyword(s):  
Cruciate Ligaments ◽  
Anterior Cruciate Ligaments ◽  
Anterior Cruciate

scholarly journals IS PERCUTANEOUS MEDIAL COLLATERAL LIGAMENT (MCL) RELAXATION DURING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION A SAFE OPTION FOR GAINING ACCESS TO THE MEDIAL KNEE COMPARTMENT IN CHILDREN?

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0004
Author(s):  
John A. Schlechter ◽  
Tanner Harrah ◽  
Bryn Gornick ◽  
Benjamin Sherman
Keyword(s):  
Anterior Cruciate Ligament ◽  
Children And Adolescents ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Adult Population ◽  
Deep Infection ◽  
Patient Reported Outcome ◽  
Collateral Ligament ◽  
Patient Reported ◽  
Anterior Cruciate

Introduction: With participation in youth sports anterior cruciate ligament (ACL) injuries are a common occurrence. Nearly 70% of ACL tears in children and adolescents have an associated meniscus tear. Percutaneous medial collateral ligament (MCL) relaxation has been described as utilitarian in accessing the medial meniscus for diagnostic assessment and treatment in the adult population to increase medial compartment working space in arthroscopic surgery. The technique has not been evaluated in the pediatric population. The purpose of this study was to compare the outcomes of children and adolescents that underwent anterior cruciate ligament reconstruction (ACLR) with and without percutaneous relaxation of the medial collateral ligament (MCL) for meniscal tear management. Methods: A retrospective review was performed of patients aged 8 to 19 years old that had undergone knee arthroscopy for an (ACLR) with meniscus pathology. Those that underwent MCL relaxation were grouped together and compared to a matched cohort that did not have MCL relaxation performed. Preoperative, operative and postoperative data was analyzed. The primary measurement was obtained using a validated patient reported outcome score (Pedi-IKDC), secondary outcome measures were defined as superficial or deep infection, saphenous nerve dysesthesias, ACL graft failure and return to the operating room. Statistical analysis of the two cohorts was performed. Results: Fifty-four patients were included in the study (27 in each group) with average age 15 years (range 10-19). Average follow-up for the MCL relaxation group was 22.4 months versus 58 months for the non-MCL relaxation group. The average Pedi-IKDC score was 93.3 for the MCL relaxation group and 91.4 for the non-MCL relaxation group (p=0.34). There was no difference in patient demographics, return to the operating room (p=0.49), saphenous nerve dysesthesia (p=0.49), superficial or deep infection (p=0.32). Conclusion: ACL reconstruction in children and adolescents with MCL relaxation for the management of medial meniscal tears appears to be a safe option. Equivocal patient reported outcome scores as compared to the control group were found with no increase in post-operative complications. In children with ACL tears, appropriate diagnosis and management of medial meniscal pathology is important to maintain secondary restraint to anterior tibial translation and prevent premature graft failure. Pediatric knees can have tight medial compartments, making access difficult, potentially leading to poor visualization and iatrogenic chondral damage. Percutaneous medial collateral ligament (MCL) relaxation has been described in the adult population to increase medial compartment working space without long term sequela. We report similar findings in an all pediatric cohort.

Comparative animal study of three ligament prostheses for the replacement of the anterior cruciate and medial collateral ligament

Biomaterials ◽  
1996 ◽  
Vol 17 (10) ◽  
pp. 977-982 ◽  
Author(s):  
Lutz Dürselen ◽  
Lutz Claes ◽  
Anita Ignatius ◽  
Siegfried Rübenacker
Keyword(s):  
Animal Study ◽  
Medial Collateral Ligament ◽  
Collateral Ligament ◽  
Anterior Cruciate
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