A Preiss1, A Giannakos, K-H Frosch. 1. Sektion Knie- und Schulterchirurgie, Sporttraumatologie, Chirurgisch-Traumatologisches Zentrum, Asklepios Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Deutschland.
Abstract
OBJECTIVE: Medial collateral ligament reconstruction in chronic unstable knees. INDICATIONS: Chronic instability of the medial collateral ligament (MCL) isolated or in combination with multiligament injuries. CONTRAINDICATIONS: Refixable bony avulsions, limited range of motion, arthrofibrosis, severe valgus deformity, infections, critical soft tissue, lack of patient compliance and open growth plates. SURGICAL TECHNIQUE: Harvesting of the contralateral semitendinosus tendon and preparation. Supine position with leg in electric leg holder. Oblique skin incision above the pes anserinus parallel to the tendons. Placement of drill hole distal to the tibial insertion of the hamstrings in the footprint of the MCL. Tapering and fixation of the transplant. Subfascial tunneling and femoral fixation of the transplant distally to the medial patellofemoral ligament (MPFL) origin in 30° flexion under fluoroscopic control. Tibial fixation of the dorsal portion of the transplant (POL) ventral to the semimembranosus tendon footprint in full extension. POSTOPERATIVE MANAGEMENT: Limited weight bearing with 20 kg for 4-6 weeks, stabilizing brace with limited range of motion 0/0/90°. RESULTS: A total of 9 patients with a median age of 39 (18-70) years received an augmentation of the MCL complex due to a chronic instability using the described technique. Follow-up examination was performed after 16 (11-56) months. All patients reported a stable knee. The median value of the Lysholm score at follow-up was 90 (72-96) points and the Tegner score prior to trauma was 4 (2-6) points and 3 (2-6) points during follow-up. No grade 2 or 3 instability could be observed during follow-up. There were no complications using the above mentioned technique.
OBJECTIVE: Medial collateral ligament reconstruction in chronic unstable knees. INDICATIONS: Chronic instability of the medial collateral ligament (MCL) isolated or in combination with multiligament injuries. CONTRAINDICATIONS: Refixable bony avulsions, limited range of motion, arthrofibrosis, severe valgus deformity, infections, critical soft tissue, lack of patient compliance and open growth plates. SURGICAL TECHNIQUE: Harvesting of the contralateral semitendinosus tendon and preparation. Supine position with leg in electric leg holder. Oblique skin incision above the pes anserinus parallel to the tendons. Placement of drill hole distal to the tibial insertion of the hamstrings in the footprint of the MCL. Tapering and fixation of the transplant. Subfascial tunneling and femoral fixation of the transplant distally to the medial patellofemoral ligament (MPFL) origin in 30° flexion under fluoroscopic control. Tibial fixation of the dorsal portion of the transplant (POL) ventral to the semimembranosus tendon footprint in full extension. POSTOPERATIVE MANAGEMENT: Limited weight bearing with 20 kg for 4-6 weeks, stabilizing brace with limited range of motion 0/0/90°. RESULTS: A total of 9 patients with a median age of 39 (18-70) years received an augmentation of the MCL complex due to a chronic instability using the described technique. Follow-up examination was performed after 16 (11-56) months. All patients reported a stable knee. The median value of the Lysholm score at follow-up was 90 (72-96) points and the Tegner score prior to trauma was 4 (2-6) points and 3 (2-6) points during follow-up. No grade 2 or 3 instability could be observed during follow-up. There were no complications using the above mentioned technique.
Authors: S D Kwak; C S Ahmad; T R Gardner; R P Grelsamer; J H Henry; L Blankevoort; G A Ateshian; V C Mow Journal: J Orthop Res Date: 2000-01 Impact factor: 3.494
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Authors: C Domnick; M Herbort; M J Raschke; B Schliemann; R Siebold; R Śmigielski; C Fink Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-08-14 Impact factor: 4.342
Authors: Lena Alm; Tobias Claus Drenck; Jannik Frings; Matthias Krause; Alexander Korthaus; Anna Krukenberg; Karl-Heinz Frosch; Ralph Akoto Journal: Orthop J Sports Med Date: 2021-03-15
Authors: Daniel Guenther; Thomas Pfeiffer; Wolf Petersen; Andreas Imhoff; Mirco Herbort; Andrea Achtnich; Thomas Stein; Christoph Kittl; Christian Schoepp; Ralph Akoto; Jürgen Höher; Sven Scheffler; Amelie Stöhr; Thomas Stoffels; Julian Mehl; Tobias Jung; Andree Ellermann; Christian Eberle; Cara Vernacchia; Patricia Lutz; Matthias Krause; Natalie Mengis; Peter E Müller; Thomas Patt; Raymond Best Journal: Orthop J Sports Med Date: 2021-11-29