scholarly journals Percutaneous Superficial Medial Collateral Ligament Release Outcomes During Medial Meniscal Arthroscopy: A Systematic Review

2020 ◽  
Vol 2 (2) ◽  
pp. e153-e159
Author(s):  
Michael A. Gaudiani ◽  
Derrick M. Knapik ◽  
Matthew W. Kaufman ◽  
Michael J. Salata ◽  
James E. Voos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medial Collateral Ligament ◽  
Collateral Ligament ◽  
Superficial Medial Collateral Ligament

scholarly journals Medial Collateral Ligament Reconstruction in Patients With Medial Knee Instability: A Systematic Review

2017 ◽  
Vol 5 (5) ◽  
pp. 232596711770392 ◽  
Author(s):  
Antonios N. Varelas ◽  
Brandon J. Erickson ◽  
Gregory L. Cvetanovich ◽  
Bernard R. Bach
Keyword(s):  
Systematic Review ◽  
Range Of Motion ◽  
Medial Collateral Ligament ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Collateral Ligament ◽  
Level Of Evidence ◽  
Cruciate Ligament Reconstruction ◽  
Significant Difference ◽  
Ikdc Score

Background: The medial collateral ligament (MCL) is the most frequently injured ligament of the knee, but it infrequently requires surgical treatment. Current literature on MCL reconstructions is sparse and offers mixed outcome measures. Purpose/Hypothesis: The purpose of this study was to compare the outcomes of isolated MCL reconstruction and multiligamentous MCL reconstruction. Our hypothesis was that in selective patients, MCL reconstruction would significantly improve objective and subjective patient knee performance measures, those being baseline valgus laxity, range of motion, objective and subjective International Knee Documentation Committee (IKDC) scores, Tegner score, and Lysholm knee activity scores. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and utilizing 3 computer-based databases. Studies reporting clinical outcomes of patients undergoing MCL reconstruction due to chronic instability or injury with mean follow-up of at least 2 years and levels of evidence 1 to 4 were eligible for inclusion. All relevant subject demographics and study data were statistically analyzed using 2-sample and 2-proportion z tests. Results: Ten studies involving 275 patients met our inclusion criteria. Of these patients, 46 underwent isolated MCL reconstruction while another 229 underwent reconstruction of the MCL in addition to a variety of concomitant reconstructions. Overall outcomes for all patients were significant for (1) reducing the medial opening of the knee (8.1 ± 1.3 vs 1.4 ± 1.0 mm; P < .001), (2) improving the patient’s objective IKDC score (1.2% vs 88.4%; P < .001), (3) improving the patient’s subjective IKDC score (49.8 ± 6.9 vs 82.4 ± 9.6; P < .001), and (4) improving the Lysholm knee activity score (69.3 ± 5.9 vs 90.5 ± 6.6; P < .001). No differences existed between concomitant reconstruction groupings except that postoperative Lysholm scores were better for MCL/anterior cruciate ligament reconstruction than MCL/posterior cruciate ligament reconstruction (94.3 ± 4.5 vs 84.0 ± 11.7; P < .001). Normal or nearly normal range of motion was obtained by 88% of all patients. Conclusion: The systematic review of 10 studies and 275 knees found that the reported patient outcomes after MCL reconstruction were significantly improved across all measures studied, with no significant difference in outcomes between concomitant reconstructions.

Superficial Medial Collateral Ligament Anatomic Augmented Repair Versus Anatomic Reconstruction

2013 ◽  
Vol 41 (12) ◽  
pp. 2858-2866 ◽  
Author(s):  
Coen A. Wijdicks ◽  
Max P. Michalski ◽  
Matthew T. Rasmussen ◽  
Mary T. Goldsmith ◽  
Nicholas I. Kennedy ◽  
...  
Keyword(s):  
Medial Collateral Ligament ◽  
Anatomic Reconstruction ◽  
Collateral Ligament ◽  
Superficial Medial Collateral Ligament

scholarly journals Length change pattern of the medial structures of the knee and related reconstructions

2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0053
Author(s):  
Arne Olbrich ◽  
Elmar Herbst ◽  
Christoph Domnick ◽  
Johannes Glasbrenner ◽  
Michael J. Raschke ◽  
...  
Keyword(s):  
Medial Collateral Ligament ◽  
Knee Flexion ◽  
Insertion Site ◽  
Length Change ◽  
Collateral Ligament ◽  
Femoral Insertion ◽  
Superficial Medial Collateral Ligament ◽  
Custom Made ◽  
Length Changes ◽  
Length Reduction

Introduction: Aim of the study was to investigate the length changes of the medial structures and related reconstructions. It was assumed that the three fibre sections (anterior/middle/posterior) of the superficial medial collateral ligament (sMCL) have different length change patterns, which cannot be imitated by current reconstructions. Hypotheses: The three fibre sections (anterior/middle/posterior) of the superficial medial collateral ligament (sMCL) cannot be imitated by current reconstructions. Methods: Measurements were made on eight cadaveric knees. The knee joints were clamped in a custom-made open chain extension structure. For this purpose, the portions of the quadriceps and the iliotibial tract were aligned according to their fibre direction and statically loaded using hanging weights. The respective tibial and femoral insertion points of the sMCL anterior/middle/posterior fibres were marked by small pins. Similarly, pins were inserted at the tibial and femoral attachment sites of the posterior oblique ligament (POL). In order to imitate the Lind reconstruction, a pin was additionally inserted on the tibial semitendinosus insertion site. Pin combinations accounting for the anterior/middle/posterior sMCL, the POL, and the Lind reconstruction were connected using a high resistant suture. Then the length change patterns were measured using a rotary encoder from 0-120° knee flexion. Statistical analysis was performed using 2-way repeated-measures ANOVA and a post-hoc Bonferroni correction (p <0.05). Results: The anterior and posterior fibres of the sMCL showed a reciprocal behaviour (p< 0.001). The anterior fibres showed a length reduction (2%) up to a flexion of 20°, followed by an elongation of 5% at 120° flexion, which means that the anterior fibres are tight in knee flexion. Conversely, the posterior fibres of the MCL showed an initial length reduction of 4% at 20° flexion. This was followed by an isometric range (20° - 80°) and a further length reduction of 8% in deep flexion (120°). Thus, the posterior fibres of the MCL were tight in extension. The three parts of the POL showed a constant reduction of 25% between 0° and 120°. The Lind reconstruction with the tibial pin at the semitendinosus insertion site showed similar length changes compared to the sMCL (n.s.). Furthermore, the Lind reconstruction was dependent on the femoral placement of the pins (p <.001). The tibial placement had no significant influence. Conclusion: The anterior portion of the sMCL was tight in flexion, whereas the posterior portion was tight in extension. This reciprocal behavior could not be imitated by a single point to point reconstruction. When surgically applying these reconstructions, special attention should be paid to the femoral insertion.

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