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.

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.

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.

Acute Grade III Medial Collateral Ligament Injury of the Knee Associated with Anterior Cruciate Ligament Tear: The Usefulness of Magnetic Resonance Imaging in Determining a Treatment Regimen

2003 ◽  
Vol 31 (2) ◽  
pp. 261-267 ◽  
Author(s):  
Norimasa Nakamura ◽  
Shuji Horibe ◽  
Yukiyoshi Toritsuka ◽  
Tomoki Mitsuoka ◽  
Hideki Yoshikawa ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Superficial Layer ◽  
Ligament Injury ◽  
Resonance Imaging ◽  
Collateral Ligament ◽  
Medial Collateral Ligament Injury ◽  
Anterior Cruciate ◽  
Grade Iii

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.

Evaluation of the Viscoelastic Properties of the Intact Medial Collateral Ligament in a Goat Model

1999 ◽  
Author(s):  
Theodore D. Clineff ◽  
Richard E. Debski ◽  
Sven U. Scheffler ◽  
John D. Withrow ◽  
Savio L.-Y. Woo
Keyword(s):  
Medial Collateral Ligament ◽  
Viscoelastic Properties ◽  
Analytical Approach ◽  
Cruciate Ligament ◽  
Collateral Ligament ◽  
Future Studies ◽  
Linear Viscoelastic ◽  
Viscoelastic Theory ◽  
Anterior Cruciate ◽  
Linear Viscoelastic Theory

Abstract The time and history dependent viscoelastic properties have been determined for the normal medial collateral ligament (MCL) of canine (Woo, 1981), porcine anterior cruciate ligament (Kwan, 1993), and human patellar tendon in a cadaver model (Johnson, 1994). The objective of this study was to use a combined experimental and analytical approach to quantify the viscoelastic properties of the intact MCL in a goat model. A thorough understanding of the viscoelastic properties at low strain levels is necessary to future studies of the healing MCL. The quasi-linear viscoelastic theory (QLV) (Fung, 1972) was used to characterize the properties of the MCL during stress relaxation.

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