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.

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

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.

scholarly journals Differential expression of related molecules after acute injury of rabbits’ anterior cruciate ligament and medial collateral ligament

2021 ◽  
Author(s):  
Yu Wen ◽  
Yin-he Han ◽  
Huining Gu ◽  
Mingzheng Zhang ◽  
Bin Li
Keyword(s):  
Anterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Acute Injury ◽  
Ligament Injury ◽  
Type I ◽  
Mrna Levels ◽  
Collateral Ligament ◽  
Medial Collateral Ligament Injury ◽  
Anterior Cruciate

Abstract Objective: This study aimed to assay expression of the mRNA and proteins for injuring- and angiogenesis-associated molecules at 3 days, 1week, 2weeks, 4weeks and 6 weeks after anterior cruciate ligament or medial collateral ligament injury in male New Zealand White rabbits.Methods: Models similar to those of clinical patients were used to establish acute partial injuries of the anterior cruciate ligament and medial collateral ligament at 3 days, 1 week, 2 weeks, 4 weeks and 6 weeks and normal control groups. Molecular biological changes in male rabbits were detected at different time points after anterior cruciate ligament and medial collateral ligament injury by H&E staining, reverse transcriptase chain reaction and westren blotting.Results: Marked differences were found in the postinjury changes in gene levels and proteins in the anterior cruciate ligament compared to the medial collateral ligament. There was no increase in mRNA expression of TIMP3, TGF-βand PRG4 in the injured anterior cruciate ligament at any time point. However, the levels of these genes tended to increase in the injured medial collateral ligament. In contrast, MMP-13 mRNA levels were significantly increased in the injured anterior cruciate ligament, but not in the medial collateral ligament. Furthermore, vascular endothelial growth factor decreased following injury to both the anterior cruciate ligament and medial collateral ligament, with the difference being a slight decrease in the medial collateral ligament and a significant decrease in the anterior cruciate ligament. Similarly, protein blots showed higher protein expression of type I and type III collagen in the injured medial collateral ligament than in the anterior cruciate ligament.Conclusion: The results show that there were drastic differences in angiogenesis, collagen and Matrix metalloproteinases after anterior cruciate ligament and medial collateral ligament injury. It can be found that the repair ability of the anterior cruciate ligament and medial collateral ligament after injury may be related to the differences in molecular expression.

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

2009 ◽  
Vol 2 (1) ◽  
pp. 73-77 ◽  
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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