Surgical Technique for the Use of Allografts as Anterior Cruciate Ligament, Posterior Cruciate Ligament, Medial Collateral Ligament, and Lateral Collateral Ligament Substitutes

1993 ◽  
Vol 1 (1) ◽  
pp. 92 ◽  
Author(s):  
Lonnie E. Paulos ◽  
Jerry L. Cooper
Keyword(s):  
Anterior Cruciate Ligament ◽  
Surgical Technique ◽  
Posterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Collateral Ligament ◽  
Anterior Cruciate

scholarly journals Simultaneous reconstruction of anterior cruciate ligament (ACL) with autologous graft and of medial collateral ligament (MCL) with allograft

2014 ◽  
Vol 2 (12_suppl4) ◽  
pp. 2325967114S0024
Author(s):  
José Luis Aparicio ◽  
Lisandro Nardin ◽  
Matías S. Savá
Keyword(s):  
Anterior Cruciate Ligament ◽  
Surgical Technique ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Anatomical Reconstruction ◽  
Collateral Ligament ◽  
Autologous Graft ◽  
Simultaneous Reconstruction ◽  
Titanium Screws ◽  
Anterior Cruciate

Introduction: Over the last years, the incidence of multiple ligament injuries has increased significantly due to the rising number of traffic accidents in relation to their kinetics and due to higher sports demands. Among their various combinations, one of them is the lesion of anterior cruciate ligament (ACL) which is associated to medial collateral ligament responsible for them in a 13 %. Nowadays several techniques to the reconstruction of Anterior Cruciate Ligament (ACL) and Medial Collateral Ligament (MCL) are applied. Therefore, for the last three years, we have carried out the simultaneous reconstruction of ACL with autologous graft and of MCL with allograft. Benefits include avoidance of morbidity in multiple donor areas, a safe bone-to-bone fixation in the case of Achilles tendon grafting; tiny incisions in the skin , and anatomical reconstruction. Throughout the years, the use of allografts has been very frequent. This is due to their safety factors, accessibility and their functional outcomes in the long term. Objectives: Show our surgical technique and experience in the combined reconstruction of anterior cruciate ligament with autologous graft and of medial collateral ligament with allograft. Methods: Fourteen (14) patients, with an average age of 29, were evaluated after they had undergone a reconstruction of ACL and MCL with autologous graft and allograft respectively. Average follow-up was 19.6 months. With respect to the surgical technique, it comprises two small incisions placing the anatomical femoral and tibial insertion for the MCL, and arthroscopically the anatomical location of the LCA. Later, some corresponding holes are made to be fixed with blunt Titanium screws following the same procedure. Mobility, joint laxity and subjective functionality were evaluated by means of Lysholm scores and International Knee Documentation Committee (IKDC). Results: The Average Lysholm knee score was 93, while all the patients were classified A/B according to the IKDC and were able to return to their normal sport and daily activity. Their range of motion remained stable. Conclusion: In multiple ligament knee injury, the use of allografts or in combination with autologous graft has become a valid resource. The lower risk of morbidity from the donor zone, the lower exposure of tissues, the lower postoperative pain with the MCL allograft at a low cost and greater security with ACL autologous graft have turned this surgical technique in a viable option for multi-ligament injured knee reconstruction.

Incidence of Associated Knee Lesions with Torn Anterior Cruciate Ligament: Retrospective Cohort Assessment

1998 ◽  
Vol 7 (1) ◽  
pp. 1-8 ◽  
Author(s):  
George A. Arangio ◽  
Edward W. Cohen
Keyword(s):  
Anterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Lateral Collateral Ligament ◽  
Collateral Ligament ◽  
Posterior Oblique Ligament ◽  
Anterior Cruciate Ligament Injuries ◽  
Arcuate Ligament ◽  
Anterior Cruciate

The records of 141 consecutive patients with confirmed complete anterior cruciate ligament injuries were reviewed retrospectively. One hundred and sixty-two associated injuries were divided into 25 injury complexes. Isolated injuries to the anterior cruciate ligament occurred in 40 cases (28.4%). Injuries of the medial meniscus occurred in 62 cases (38.2%), while injuries of the lateral meniscus occurred in 37 cases (22.8%). Injuries to the medial collateral ligament complex occurred in 42 cases (25.9%). Injuries to the lateral collateral ligament, posterior deep popliteus-arcuate ligament complex, and posterior cruciate ligament were found to be positively correlated (rho = .81, p = .001, and rho = .77, p = .001, N = 141, respectively). Injuries to the medial collateral ligament and the posterior oblique ligament were likewise positively correlated (rho = .45, p = .001, N = 141).

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 Simultaneous Reconstruction of Anterior Cruciate Ligament with Autologous Tendon Grafts and Medial Collateral Ligament with Allograft

2018 ◽  
Vol 6 (12_suppl5) ◽  
pp. 2325967118S0018
Author(s):  
Lisandro Nardin ◽  
Matías Savá ◽  
Oscar Calvet ◽  
Fernando Mercier ◽  
Abel Barck ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Surgical Technique ◽  
Medial Collateral Ligament ◽  
Low Cost ◽  
Cruciate Ligament ◽  
Functional Results ◽  
International Knee Documentation Committee ◽  
Collateral Ligament ◽  
Simultaneous Reconstruction ◽  
Anterior Cruciate

Objectives: Our objective is to show our surgical technique and experience in the combined reconstruction of ACL with autograft (either BTB or STGT) and MCL with allograft. (Aquiles Tendon) Methods: Twenty eight (28) patients, with an average age of 29,5, to whom an ACL and an MCL reconstruction with auto graft and allogeneic graft respectively was performed. These patients experienced residual internal instability after conservative treatment. Average follow-up was 19.6 months. Range of motion, joint laxity and subjective functionality were evaluated whit Lysholm scores and International Knee Documentation Committee (IKDC). Results: The Average Lysholm knee score was 93, while all the patients were classified A/B according to the IKDC and were able to return to their normal sport and daily activity. Conclusion: Nowadays various reconstructive techniques of anterior cruciate ligament (ACL) and of medial collateral ligament (MCL) are being utilized. Over the years the use of allografts have become common due to their safety, accesibility and satisfactory functional results. In multi-ligament injuries the single use of allografts or in combination with autologous grafts have become a valid resource. The lower risk of morbidity from the donor zone, the lower exposure of tissues, the lower postoperative pain with the MCL allogeneic graft at a low cost and greater security with ACL autologous graft have turned this surgical technique in a viable option for multi-ligament injured knee reconstruction.

scholarly journals Tissue-specific changes in size and shape of the ligaments and tendons of the porcine knee during post-natal growth

2019 ◽  
Author(s):  
Stephanie G. Cone ◽  
Hope E. Piercy ◽  
Emily P. Lambeth ◽  
Hongyu Ru ◽  
Jorge A. Piedrahita ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Patellar Tendon ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Collateral Ligament ◽  
Cross Sectional ◽  
Anterior Cruciate

AbstractPrior studies have analyzed growth of musculoskeletal tissues between species or across body segments; however, little research has assessed the differences in similar tissues within a single joint. Here we studied changes in the length and cross-sectional area of four ligaments and tendons, (anterior cruciate ligament, patellar tendon, medial collateral ligament, lateral collateral ligament) in the tibiofemoral joint of female Yorkshire pigs through high-field magnetic resonance imaging throughout growth. Tissue lengths increased by 4-to 5-fold from birth to late adolescence across the tissues while tissue cross-sectional area increased by 10-20-fold. The anterior cruciate ligament and lateral collateral ligament showed allometric growth favoring change in length over change in cross-sectional area while the patellar tendon and medial collateral ligament grow in an isometric manner. Additionally, changes in the length and cross-sectional area of the anterior cruciate ligament did not increase as much as in the other ligaments and tendon of interest. Overall, these findings suggest that musculoskeletal soft tissue morphometry can vary within tissues of similar structure and within a single joint during post-natal growth.

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.

scholarly journals Imaging Findings of Knee Trauma on Magnetic Resonance Imaging

2022 ◽  
Vol 8 (1) ◽  
pp. 12-23
Author(s):  
Poonam Ohri ◽  
Shreeji Goya ◽  
Niveditha C ◽  
Manasi Kohli
Keyword(s):  
Anterior Cruciate Ligament ◽  
Imaging Modality ◽  
Cruciate Ligament ◽  
Age Groups ◽  
Lateral Collateral Ligament ◽  
Cost Effective ◽  
Collateral Ligament ◽  
Imaging Evaluation ◽  
Young Males ◽  
Anterior Cruciate

Background: Knee is one of the major joints involved in kinesis. With increasing involvement in sports related activities especially in young people, Trauma related knee pathologies have increased. An accurate diagnosis regarding the type and extent of injuries is essential for early operative as well as non-operative treatment. Methods:This prospective study included total of 82 cases. The patients were referred to the department of Radiodiagnosis from indoor and outdoor departments of Guru Nanak Dev Hospital, Amritsar with suspicion of internal derangement of the knee and with history of knee trauma.Results:The most common age group involved was young males between 15-34 years. In all age groups most of the patients were males. Most common ligament to be injured was Anterior Cruciate Ligament (ACL). Partial tears were more common than complete tears. Posterior Cruciate Ligament (PCL) tears were less common. Medial Collateral Ligament (MCL) tears outnumbered Lateral Collateral Ligament (LCL) tears and grade 2 tears were more common in both. Among the meniscal injuries Medial Meniscus (MM) tears were more common than LM and grade 3 signal was more common in both. Most of the patellar retinaculum injuries were associated with Anterior Cruciate Ligament ACL tears.Conclusions:Post-traumatic pre-arthroscopic MR imaging evaluation has proved to be cost-effective. MRI is an accurate imaging modality complementing the clinical evaluation and providing a global intra-articular and extra-articular assessment of the knee.

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