Bohan Zhang1, Yinqiao Du2, Jingyang Sun2, Junmin Shen2, Tiejian Li2, Yonggang Zhou2. 1. Department of Orthopedics, the First Medical Centre of Chinese PLA General Hospital, Beijing, 100853, P.R.China;Medical School of Chinese PLA, Beijing, 100853, P.R.China. 2. Department of Orthopedics, the First Medical Centre of Chinese PLA General Hospital, Beijing, 100853, P.R.China.
Abstract
OBJECTIVE: To summarize the prevention and treatment of iatrogenic medial collateral ligament (MCL) injuries in total knee arthroplasty (TKA). METHODS: The relevant literature about iatrogenic MCL injuries in TKA was summarized, and the symptoms, causes, preventions, and treatments were analyzed. RESULTS: Preventions on the iatrogenic MCL injuries in TKA is significantly promoted. With the occurrence of MCL injuries, the femoral avulsion can be fixed with the screw and washer or the suture anchors; the tibial avulsion can be treated with the suture anchors fixation, bone staples fixation, or conservative treatment; the mid-substance laceration can be repaired directly; the autologous quadriceps tendon, semitendinosus tendon, or artificial ligament can be used for the patients with poor tissue conditions or obvious residual gap between the ligament ends; the use of implant with greater constraint can be the last alternative method. CONCLUSION: No consensus has been reached to the management of iatrogenic MCL injuries in TKA. Different solutions and strategies can be integrated and adopted flexibly by surgeons according to the specific situation.
OBJECTIVE: To summarize the prevention and treatment of iatrogenic medial collateral ligament (MCL) injuries in total knee arthroplasty (TKA). METHODS: The relevant literature about iatrogenic MCL injuries in TKA was summarized, and the symptoms, causes, preventions, and treatments were analyzed. RESULTS: Preventions on the iatrogenic MCL injuries in TKA is significantly promoted. With the occurrence of MCL injuries, the femoral avulsion can be fixed with the screw and washer or the suture anchors; the tibial avulsion can be treated with the suture anchors fixation, bone staples fixation, or conservative treatment; the mid-substance laceration can be repaired directly; the autologous quadriceps tendon, semitendinosus tendon, or artificial ligament can be used for the patients with poor tissue conditions or obvious residual gap between the ligament ends; the use of implant with greater constraint can be the last alternative method. CONCLUSION: No consensus has been reached to the management of iatrogenic MCL injuries in TKA. Different solutions and strategies can be integrated and adopted flexibly by surgeons according to the specific situation.
Entities:
Keywords:
Total knee arthroplasty; iatrogenic injury; medial collateral ligament; prevention and treatment
Authors: Shady S Elmasry; Peter K Sculco; Mohammad Kia; Cynthia A Kahlenberg; Michael B Cross; Andrew D Pearle; David J Mayman; Timothy M Wright; Geoffrey H Westrich; Carl W Imhauser Journal: J Orthop Res Date: 2020-05-25 Impact factor: 3.494