scholarly journals Anatomic reconstruction of the medial collateral ligament in multi-ligaments knee injury using achilles allograft : a modification of Marx’s technique

2021 ◽  
Vol 87 (2) ◽  
pp. 359-365
Author(s):  
Hamidreza Yazdi ◽  
John Y. Kwon ◽  
Mohammad Ghorbanhoseini ◽  
Alireza Yousof Gomrokchi ◽  
Paniz Motaghi
Keyword(s):  
Medial Collateral Ligament ◽  
Lysholm Score ◽  
Hardware Removal ◽  
Anatomic Reconstruction ◽  
Collateral Ligament ◽  
Knee Motion ◽  
Knee Ligament ◽  
Second Surgery ◽  
Subjective Score ◽  
Valgus Instability

Medial Collateral Ligament (MCL) injury may require operative treatment. Marx et al. described the latest technique for reconstruction of MCL. While good results have been reported using the Marx technique, some issues have been observed. To address the mentioned issues, a modification to the Marx technique has been devised. Eleven patients were enrolled and their ligaments were repaired by the fixation of allograft on the proximal and distal attachment footprints of the superficial MCL. For preventing loss of knee ROM, MCL and other ligaments were reconstructed in 2 separate stages. At the last follow up the ROM, knee ligament laxity and functional outcome scores, subjective (IKDC) and Lysholm score were evaluated and recorded. Knee motion was maintained in all cases. Two cases demonstrated 1+ valgus instability at 30 degrees of knee flexion. Both were treated for combined MCL and PCL tear, the rest were stable. The average IKDC-subjective score was 93 ± 4 and the average Lysholm score was 92 ± 3. All patients were satisfied and returned to their previous level of activity. In this technique, the superficial MCL was recon- structed closer to its anatomical construct. Patients didn’t have any complaints of hardware under the skin and the need for a second surgery for hardware removal was avoided. Patients didn’t have any complaints of hardware under the skin and the need for a second surgery for hardware removal was avoided. Also reconstructing the ligaments in 2 stages helped to preserve the knee motion.

scholarly journals Open Anatomic Reconstruction of the Medial Collateral Ligament and Posteromedial Corner

2015 ◽  
Vol 4 (6) ◽  
pp. e885-e890 ◽  
Author(s):  
Matthew R. Prince ◽  
Andrew J. Blackman ◽  
Alexander H. King ◽  
Michael J. Stuart ◽  
Bruce A. Levy
Keyword(s):  
Medial Collateral Ligament ◽  
Anatomic Reconstruction ◽  
Collateral Ligament ◽  
Posteromedial Corner

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

Valgus Instability of the Elbow Due to Medial Epicondyle Nonunion: Treatment by Fragment Excision and Medial Collateral Ligament Reconstruction

2017 ◽  
Vol 22 (01) ◽  
pp. 70-74 ◽  
Author(s):  
Yasunori Kaneshiro ◽  
Noriaki Hidaka ◽  
Koichi Yano ◽  
Makoto Fukuda ◽  
Hideki Sakanaka
Keyword(s):  
Range Of Motion ◽  
Medial Collateral Ligament ◽  
Ligament Reconstruction ◽  
Signs And Symptoms ◽  
Medial Epicondyle ◽  
Collateral Ligament ◽  
Valgus Instability ◽  
Bone Fragments ◽  
The Mean ◽  
Fragment Excision

Background: The medial epicondyle nonunion becomes symptomatic valgus instability with medial elbow pain and joint instability due to dysfunction of the medial collateral ligament (MCL), thus requiring surgical treatment. The purpose of the present study is to report the clinical result of the fragment excision and ligament reconstruction by free tendon graft in the treatment of symptomatic medial epicondyle nonunion. Methods: A retrospective study of five consecutive patients was performed. All five patients had signs and symptoms of valgus instability of the elbow. The mean period of nonunion was 25 years, and their injuries progressed asymptomatically until symptoms developed in adulthood after a second injury. Results: All patients were treated by fragment excision and MCL reconstruction. At the final follow-up, no patients exhibited pain or instability. The mean joint range of motion was 0o of extension and 138o of flexion, with an MEPS of 100 points in all patients. Conclusions: By ligament reconstruction for MCL insufficiency and removing the bone fragments avoided irritation by the bone fragments, pain and instability disappeared, good range of motion was restored, and excellent outcomes were achieved in all patients. We believe that fragment excision and MCL reconstruction should be considered as the treatment option for symptomatic medial epicondyle nonunion of the humerus.

Medial Collateral Ligament Reconstruction of the Elbow using the Docking Technique

2002 ◽  
Vol 30 (4) ◽  
pp. 541-548 ◽  
Author(s):  
Joel T. Rohrbough ◽  
David W. Altchek ◽  
Jon Hyman ◽  
Riley J. Williams ◽  
Jonathan D. Botts
Keyword(s):  
Medial Collateral Ligament ◽  
Collegiate Athletes ◽  
Tendon Graft ◽  
Collateral Ligament ◽  
Associated Lesions ◽  
Competition Level ◽  
Medial Collateral Ligament Reconstruction ◽  
Valgus Instability ◽  
Graft Reconstruction

Background Medial collateral ligament insufficiency of the elbow with resultant valgus instability in throwing athletes is typically treated with free tendon graft reconstruction as described by Jobe. Hypothesis Improved results could be obtained with the use of the docking technique. Study Design Uncontrolled retrospective review. Methods The study group consisted of 36 athletes who had symptomatic insufficiency of the medial collateral ligament confirmed by magnetic resonance imaging and by surgical findings. Average follow-up was 3.3 years. Key elements of the docking technique included a muscle-splitting approach without routine transposition of the ulnar nerve, routine arthroscopic assessment, treatment of associated lesions, and docking the two ends of the tendon graft into a single humeral tunnel. Results Thirty-three of 36 patients (92%) returned to or exceeded their previous level of competition for at least 1 year, meeting the Conway-Jobe classification criteria of “excellent.” All 22 professional or collegiate athletes returned to or exceeded their previous competition level. Conclusions The docking technique allowed simplified graft tensioning and improved graft fixation.

Acute reconstruction of the medial collateral ligament of the elbow for severe valgus instability after anterior elbow dislocation

2010 ◽  
Vol 15 (4) ◽  
pp. 594-597
Author(s):  
Elias Fotiadis ◽  
Theodoros Svarnas ◽  
Efthimios Iliopoulos ◽  
Alexis Papadopoulos ◽  
Apostolos Gantsos ◽  
...  
Keyword(s):  
Medial Collateral Ligament ◽  
Elbow Dislocation ◽  
Collateral Ligament ◽  
Valgus Instability

scholarly journals Isolated medial collateral ligament tears

2018 ◽  
Vol 3 (7) ◽  
pp. 398-407 ◽  
Author(s):  
Carlos A. Encinas-Ullán ◽  
E. Carlos Rodríguez-Merchán
Keyword(s):  
Surgical Treatment ◽  
Medial Collateral Ligament ◽  
Primary Repair ◽  
Ligament Injury ◽  
Collateral Ligament ◽  
Knee Ligament ◽  
Bony Avulsion ◽  
Non Surgical Treatment ◽  
Grade Iii

Tears of the medial collateral ligament (MCL) are the most common knee ligament injury. Incomplete tears (grade I, II) and isolated tears (grade III) of the MCL without valgus instability can be treated without surgery, with early functional rehabilitation. Failure of non-surgical treatment can result in debilitating, persistent medial instability, secondary dysfunction of the anterior cruciate ligament, weakness, and osteoarthritis. Reconstruction or repair of the MCL is a relatively uncommon procedure, as non-surgical treatment is often successful at returning patients to their prior level of function. Acute repair is indicated in isolated grade III tears with severe valgus alignment, MCL entrapment over pes anserinus, or intra-articular or bony avulsion. The indication for primary repair is based on the resulting quality of the native ligament and the time since the injury. Primary repair of the MCL is usually performed within 7 to 10 days after the injury. Augmentation repair for the superficial MCL (sMCL) is a surgical technique that can be used when the resulting quality of the native ligament makes primary repair impossible. Reconstruction is indicated when MCL injuries fail to heal in neutral or varus alignment. Reconstruction might be advisable to correct chronic instability. Chronic, medial-sided knee injuries with valgus misalignment should be treated with a two-stage approach. A distal femoral osteotomy should be performed first, followed by reconstruction of the medial knee structures.Cite this article: EFORT Open Rev 2018;3:398-407. DOI: 10.1302/2058-5241.3.170035

Kinematic Analysis of the Lolotte Technique in Rock Climbing

2017 ◽  
Author(s):  
Alessio Artoni ◽  
Matilde Tomasi ◽  
Francesca Di Puccio
Keyword(s):  
Knee Joint ◽  
Medial Collateral Ligament ◽  
Kinematic Analysis ◽  
Joint Angle ◽  
Rock Climbing ◽  
Lower Limbs ◽  
Biomechanical Analysis ◽  
Collateral Ligament ◽  
Knee Ligament ◽  
Knee Joint Angle

The lolotte or drop-knee technique is a fundamental of rock climbing that particularly involves lower limbs, and especially knee joints. To the authors’ best knowledge, no biomechanical analysis of the lolotte seems to have ever been conducted, despite its widespread use. As a first contribution to this research topic, the present work deals with an athlete-specific kinematic analysis of the lolotte aimed at quantifying the hip and knee joint angle trajectories and knee ligament strains. A marker-based motion capture system was employed to track the execution of the lolotte on a purposely designed climbing structure. The marker trajectories were then used as input for a numerical simulation in the OpenSim program, where an athlete-specific musculoskeletal model was set up to perform an inverse kinematics analysis and obtain the joint angle trajectories as well as their ranges of motion. Further processing of the model allowed to estimate the strain of the knee medial collateral ligament. Such kinematic analysis revealed characteristic hip and knee joint angle patterns and highlighted a critical phase in which the knee is considerably abducted (increased valgus). As a consequence, the medial collateral ligament is remarkably recruited, thereby substantiating the claim diffused among climbers that drop-kneeing may cause ligament injury.

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