Medial knee instability complicating the Pavlik-harness treatment of congenital hip subluxation. Case report.

1983 ◽  
Vol 65 (5) ◽  
pp. 678-680 ◽  
Author(s):  
E P Schwentker ◽  
R J Zaleski ◽  
S R Skinner
Keyword(s):  
Case Report ◽  
Knee Instability ◽  
Pavlik Harness ◽  
Medial Knee

scholarly journals Lower Failure Rates and Improved Patient Outcome Due to Reconstruction of the MCL and Revision ACL Reconstruction in Chronic Medial Knee Instability

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712198931
Author(s):  
Lena Alm ◽  
Tobias Claus Drenck ◽  
Jannik Frings ◽  
Matthias Krause ◽  
Alexander Korthaus ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Lysholm Score ◽  
Knee Instability ◽  
Failure Rates ◽  
Medial Knee ◽  
Revision Acl Reconstruction ◽  
Risk Of Failure ◽  
Significant Difference ◽  
Patient Reported ◽  
Reconstruction Group

Background: Concomitant lesion of the medial collateral ligament (MCL) is associated with a greater risk of anterior cruciate ligament (ACL) graft failure. Purpose: The aim of this study was to compare two medial stabilization techniques in patients with revision ACL reconstruction (ACLR) and concomitant chronic medial knee instability. Study Design: Cohort study; Level of evidence, 3. Methods: In a retrospective study, we included 53 patients with revision ACLR and chronic grade 2 medial knee instability to compare medial surgical techniques (MCL reconstruction [n = 17] vs repair [n = 36]). Postoperative failure of the revision ACLR (primary aim) was defined as side-to-side difference in Rolimeter testing ≥5 mm or pivot-shift grade ≥2. Clinical parameters and postoperative functional scores (secondary aim) were evaluated with a mean ± SD follow-up of 28.8 ± 9 months (range, 24-69 months). Results: Revision ACLR was performed in 53 patients with additional grade 2 medial instability (men, n = 33; women, n = 20; mean age, 31.3 ± 12 years). Failure occurred in 5.9% (n = 1) in the MCL reconstruction group, whereas 36.1% (n = 13) of patients with MCL repair showed a failed revision ACLR ( P = .02). In the postoperative assessment, the anterior side-to-side difference in Rolimeter testing was significantly reduced (1.5 ± 1.9 mm vs 2.9 ± 2.3 mm; P = .037), and medial knee instability occurred significantly less (18% vs 50%; P = .025) in the MCL reconstruction group than in the MCL repair group. In the logistic regression, patients showed a 9-times elevated risk of failure when an MCL repair was performed ( P = .043). Patient-reported outcomes were increased in the MCL reconstruction group as compared with MCL repair, but only the Lysholm score showed a significant difference (Tegner, 5.6 ± 1.9 vs 5.3 ± 1.6; International Knee Documentation Committee, 80.3 ± 16.6 vs 73.6 ± 16.4; Lysholm, 82.9 ± 13.6 vs 75.1 ± 21.1 [ P = .047]). Conclusion: MCL reconstruction led to lower failure rates in patients with combined revision ACLR and chronic medial instability as compared with MCL repair. MCL reconstruction was superior to MCL repair, as lower postoperative anterior instability, an increased Lysholm score, and less medial instability were present after revision ACLR. MCL repair was associated with a 9-times greater risk of failure.

Single time angular deformity correction and treatment of knee instability in congenital fibular hemimelia. A case report

The Knee ◽  
2012 ◽  
Vol 19 (4) ◽  
pp. 504-507 ◽  
Author(s):  
David Figueroa ◽  
Rafael Calvo ◽  
Ignacio E. Villalón ◽  
Andrés Schmidt-Hebbel ◽  
Francisco Figueroa ◽  
...  
Keyword(s):  
Case Report ◽  
Deformity Correction ◽  
Knee Instability ◽  
Angular Deformity ◽  
Single Time ◽  
Fibular Hemimelia

scholarly journals Isolated distal adductor magnus tendon avulsion as a rare cause of medial knee pain. A case report

2020 ◽  
Vol 30 (4) ◽  
pp. 507
Author(s):  
Rajesh Botchu ◽  
Aamer Iqbal ◽  
Shekhar Kalia ◽  
David Beale ◽  
StevenL James
Keyword(s):  
Case Report ◽  
Knee Pain ◽  
Medial Knee ◽  
Adductor Magnus ◽  
Tendon Avulsion

scholarly journals Percutaneous MCL reconstruction technique in acute anterior medial knee instability using cadaveric grafts

2014 ◽  
Vol 2 (12_suppl4) ◽  
pp. 2325967114S0025
Author(s):  
Jorge Batista ◽  
Rodrigo Maestu ◽  
Sebastián Teper ◽  
Manuel Ocampo ◽  
German Antúnez ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Functional Results ◽  
Lysholm Score ◽  
High Rate ◽  
Knee Instability ◽  
Reconstruction Technique ◽  
Medial Knee ◽  
Acute Injuries ◽  
Anterior Cruciate

Purpose: There are several alternatives described for the treatment of acute injuries of the anterior cruciate ligament (ACL ) and the medial collateral ligament (MCL) of the knee. We present the result of the combined ACL reconstruction and MCL in the same surgical procedure using only percutaneous cadaveric graft in the reconstruction of the MCL ligament. Methods: We retrospectively analyzed 30 patients with acute anterior and medial knee instability surgically treated between August 2007 and September 2013. 27 men and 3 women , mean age 30.53 years (range 18-46 ) The level of pre and post surgical activity was determined by the Tegner score , while the function was evaluated using the Lysholm score and IKDC grade Results: The average follow-up was 43 months (range 12-84 months). The mean Lysholm score was 91 (R, 61-100 ) . Only 19 of 30 (63.3 %) patients returned and kept the pre -injury level sports ; 26 patients IKDC : A (normal knee ), 3 patients IKDC : B (slightly abnormal knee ) and 1 patient IKDC C ( Knee abnormal) with limitation of 15 degrees of extension that had to be reoperated. Conclusion: The use of cadaveric tendons for reconstruction of MCL in combination with ACL reconstruction surgeries resulted in less postoperative pain, good functional results, and a high rate of return to competitive sport. The result of this study shows that the percutaneous reconstruction of LCM cadaveric graft is a viable option.

scholarly journals Tibial Avulsion with Intra-Articular Entrapment of Medial Collateral Ligament with Posterior Cruciate Ligament Tear with Posterior Root Medial Meniscus Tear: A Case Report of an Unusual Injury Triad

2021 ◽  
Vol 11 (8) ◽  
Author(s):  
Ishan Shevate ◽  
Girish Nathani ◽  
Ashwin Deshmukh ◽  
Anirudh Kandari
Keyword(s):  
Case Report ◽  
Medial Collateral Ligament ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Stress Test ◽  
Joint Line ◽  
Posterior Root ◽  
Collateral Ligament ◽  
Valgus Stress ◽  
Medial Knee

Introduction: The medial collateral ligament (MCL) is the most commonly injured ligament of the knee joint; however, its displacement into the medial knee compartment is rare. Traumatic posterior root of medial meniscus (PRMM) tears are commonly found in high-grade injuries involving anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) tears along with MCL tears. Diagnosis of these injuries can be made by a preoperative magnetic resonance imaging (MRI), but they can be missed at times due to severe soft-tissue swelling in the acute phase. Case Report: A 25-year-old gentleman presented with injury to the front of his left knee 5 days back. On examination, he had a Grade 3 effusion with valgus stress test and posterior drawer test being positive and medial joint line tenderness was present. A firm localized swelling was palpable on the medial joint line. MRI scan revealed a mid-substance PCL tear, ACL sprain, PRMM tear, and tibial side rupture of superficial MCL with proximally migrated wavy MCL fibers lying below the medial meniscus confirmed on arthroscopy. Medial meniscus root repair by pull through technique and PCL reconstruction with a 3-strand peroneus longus graft followed by open MCL repair with augmentation using a semitendinosus graft was performed. Postoperatively, the knee was kept in a straight knee brace for 4 weeks, followed by a hinged knee brace and appropriate physiotherapy were started. At 2 years follow-up, the patient had attained full range of knee motion with good quadriceps strength, tibial step off maintained, and negative posterior drawer test and valgus stress test. Displacement of torn MCL into the medial knee compartment is an extremely rare injury. Proximal or distal avulsion of MCL with intra-articular incarceration has been reported in isolation or associated with ACL tear. Such an injury triad as reported here has not been reported in the literature to the best of our review. Conclusion: In our case, we report a ver

scholarly journals Rapid chondrolysis of the medial knee compartment after arthroscopic meniscal resection: a case report

2016 ◽  
Vol 10 (1) ◽  
Author(s):  
Sylvain Steinmetz ◽  
François Bonnomet ◽  
Michel Rahme ◽  
Philippe Adam ◽  
Matthieu Ehlinger
Keyword(s):  
Case Report ◽  
Medial Knee

scholarly journals Revision ACL Reconstruction - A retrospective failure analysis with a mean follow up of 35 months

2020 ◽  
Vol 8 (5_suppl4) ◽  
pp. 2325967120S0030
Author(s):  
Lena Alm ◽  
Matthias Krause ◽  
Karl-Heinz Frosch ◽  
Ralph Akoto
Keyword(s):  
Acl Reconstruction ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
Knee Laxity ◽  
Knee Instability ◽  
Medial Knee ◽  
Risk Of Failure ◽  
Anterior Knee Laxity ◽  
Anterior Cruciate ◽  
Anterior Knee

Aims and Objectives: While patients following primary anterior cruciate ligament (ACL) surgery show satisfying results, the outcome after revision ACL reconstruction (ACLR) seems to be less favourable. The purpose of this study was to evaluate the outcome of patients after revision ACLR. We hypothesize that peripheral knee instabilities and further concomitant lesions are risk factors for failure of revision ACLR. Furthermore, we hypothesize that peripheral stabilisation will reduce the risk of failure. Materials and Methods: Between 2013 and 2016, 111 patients with revision ACLR (revision surgery after primary ACL reconstruction) were included in the retrospective study. All patients were clinically examined with a minimum of 2 years after revision surgery (mean 35 months) and identified as “failed revision ACLR” (side-to-side difference greater than 5mm and/or pivot-shift grade 2/3) and “stable revision ACLR”. Multiple logistic regression modeling was used to evaluate whether certain predisposing factors were associated with increased odds of failure of the revision ACLR. Results: Failure after revision ACLR occurred in 14.5% (n=16) of the cases. Preoperative medial knee instability (n=36) was associated with failure of revision ACLR, thus patients had a 17 times greater risk of failure when medial knee instability was diagnosed preoperatively. Also, the risk of failure was reduced when patients had peripheral medial (n=24) and/ or antero-lateral stabilisation (n=51). Increased posterior tibial slope (PTS, n=11 greater than 12°) and high-grade anterior knee laxity (side-to-side-difference greater than 5 mm and/or pivot-shift grade 3, n=41) were associated with failed revision ACLR. Furthermore, patients had a 9 times greater risk of failure when they were obese (BMI greater than 30 kg/m2, n=30). Also, postoperative functional scores in comparison to preoperative scores were shown to be significantly higher (Lysholm 85±27 vs. 51±31.9, p=0.024; Tegner 6.5± 1.3 vs. 4± 2.6, p=0.015). Conclusion: Results following revision anterior cruciate ligament reconstruction (ACLR) are less favourable than primary ACLR. Peripheral medial knee instability, high-grade anterior knee laxity, increased PTS and high BMI are risk factors for failure in revision ACLR while additional medial and/or antero-lateral stabilisation reduces the risk of failure.

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