Management of Combined Injuries of the Anterior Cruciate and Medial Collateral Ligaments

Kd, Shelbourne; Dv, Patel

doi:10.2106/00004623-199505000-00018

Cited by 54 publications

(45 citation statements)

References 20 publications

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“…Shelbourne [11] recommended non-operative treatment for MCL tears, with a brace for 4-8 weeks and subsequent ACL reconstruction for combined MCL/ACL injuries. Noyes [9] advised surgery to the medial ligament in athletes with gross disruption and associated ACL ruptures.…”

Section: Discussionmentioning

confidence: 99%

“…Early mobilization however may not be recommended when MCL lesions are combined with other ligament injuries, particularly those involving the ACL [1]. Good results have been reported with operative management of ACL ruptures in conjunction with non-operative management of MCL tears [11]. However, quadriceps weakness, extension loss and anterior knee pain are common complications of ACL reconstruction [6], and many patients with ACL lesions may be managed conservatively [2,3,11], with secondary reconstruction when required [8].…”

Section: Introductionmentioning

confidence: 99%

“…Good results have been reported with operative management of ACL ruptures in conjunction with non-operative management of MCL tears [11]. However, quadriceps weakness, extension loss and anterior knee pain are common complications of ACL reconstruction [6], and many patients with ACL lesions may be managed conservatively [2,3,11], with secondary reconstruction when required [8]. In combined MCL-ACL injuries surgery to the MCL with non-operative management of the ACL has been advised [5].…”

Section: Introductionmentioning

confidence: 99%

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The management of medial ligament tears in patients with combined anterior cruciate and medial ligament lesions

Shirakura

Terauchi

Katayama

et al. 2000

International Orthopaedics

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The management of patients with combined medial collateral (MCL) and anterior cruciate (ACL) rupture remains controversial. We studied 25 such patients who elected to have the ACL lesion treated conservatively; 14 underwent MCL repair with early mobilization and 11 were treated with immobilization for two weeks. The mean follow up was 5.9 years (2 to 11). There was no difference in the clinical assessment of ligamentous laxity, KT-1000 measurements or Tegner activity scores between the two groups but there were significantly higher Lysholm function scores in the operated group.Résumé Le traitement optimal des cas associant des lés-ions du ligament croisé antérieur (ACL) à des lésions médiales collatérales (MCL) est controversé. Nous avons réalisé une étude sur le suivi du traitement de telles lés-ions dans le but d'évaluer si le traitement opératoire des déchirures de MCL peut apporter une amélioration des résultats fonctionnels pour des patients choisissant de ne pas subir une reconstruction de ACL. Notre étude portait sur 14 patients ayant subi une reconstruction du MCL et 11 patients traités sans opération. Nous n'avons pas observé de différences significatives entre les deux groupes pour les tests de relâchement manuel, ni pour les mesures KT-1000, ni pour les niveaux d'activité de Tegner. En revanche les patients du groupe opératoire ont obtenu un meilleur score fonctionnel de Lysholm.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The management of medial ligament tears in patients with combined anterior cruciate and medial ligament lesions

Shirakura

Terauchi

Katayama

et al. 2000

International Orthopaedics

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“…In contrast, MCL injuries at the distal insertion site tend to have a lesser healing response, often leading to residual valgus laxity. 152 Therefore, the location of ligament damage may also affect the rehabilitation program. Injuries involving the distal aspect of the MCL may be progressed more cautiously to allow for tissue healing; in some instances, these individuals may be immobilized in a brace to allow MCL healing prior to ACL reconstruction.…”

Section: Variations Based On Concomitant Proceduresmentioning

confidence: 99%

Recent Advances in the Rehabilitation of Anterior Cruciate Ligament Injuries

Wilk¹,

Macrina²,

Cain³

et al. 2012

Journal of Orthopaedic & Sports Physical Therapy

138

124

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Synopsis Rehabilitation following anterior cruciate ligament surgery continues to change, with the current emphasis being on immediate weight bearing and range of motion, and progressive muscular strengthening, proprioception, dynamic stability, and neuromuscular control drills. The rehabilitation program should be based on scientific and clinical research and focus on specific drills and exercises designed to return the patient to the desired functional goals. The goal is to return the patient's knee to homeostasis and the patient to his or her sport or activity as safely as possible. Unique rehabilitation techniques and special considerations for the female athlete will also be discussed. The purpose of this article is to provide the reader with a thorough scientific basis for anterior cruciate ligament rehabilitation based on graft selection, patient population, and concomitant injuries. J Orthop Sports Phys Ther 2012;42(3):153–171. doi:10.2519/jospt.2012.3741

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“…Most of the authors in the literature now agree on postponing the anterior cruciate operation until a phase where the haemarthrosis, functional limitation and pain have been resolved [2,9]. Instead, when the disruption of the medial peripheral structures is significantly severe, the surgical option should be considered.…”

Section: Discussionmentioning

confidence: 99%

Two-phase surgical treatment of anteromedial knee injuries

et al. 2008

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The treatment of severe anteromedial knee injuries over the years has undergone various types of approach, changing from proposals, such as combined surgical repair of the anterior cruciate ligament and medial compartment, to the more current protocol which involves conservative treatment of the peripheral injury and later reconstruction of the anterior cruciate ligament. However, in serious ruptures of the medial ligament compartment, conservative treatment does not make it possible to recover peripheral stability, thus transferring abnormal forces onto the anterior cruciate pro-ligament graft which can gradually deteriorate the transplant itself. Thus in severe anteromedial injuries a treatment with two distinct surgical phases is proposed, using direct immediate suture of the peripheral compartment and, after a period of rehabilitation, later replacement of the anterior cruciate ligament by arthroscope graft. Given the obtained results and the few complications observed in 25 cases, it is probable that this therapeutic scheme can be proposed in selected cases of severe ligament laxity of the medial compartment associated with rupture of the anterior cruciate ligament.

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Management of Combined Injuries of the Anterior Cruciate and Medial Collateral Ligaments

Cited by 54 publications

References 20 publications

The management of medial ligament tears in patients with combined anterior cruciate and medial ligament lesions

The management of medial ligament tears in patients with combined anterior cruciate and medial ligament lesions

Recent Advances in the Rehabilitation of Anterior Cruciate Ligament Injuries

Two-phase surgical treatment of anteromedial knee injuries

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