Medial Collateral Ligament "Tibial" Injuries: Indication for Acute Repair

Wilson, Timothy C.; Satterfield, William H.; Johnson, Darren L.

doi:10.3928/0147-7447-20040401-15

Cited by 42 publications

(23 citation statements)

References 20 publications

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“…An avulsion of the MCL from the distal tibial insertion is 1 such example. 4 , 9 , 10 , 11 , 12 Unfortunately, the majority of literature discussing nonoperative and surgical management of MCL injuries does not distinguish the site of ligamentous injury, making the true incidence and associated treatment outcomes of distal injuries difficult to discern. Nevertheless, there is evidence to suggest that distal tibial MCL injuries do not do well with conservative management.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, in 2004, Wilson et al. 12 reported that a number of athletes had failed conservative management of grade III MCL injuries. These athletes were found to have complete detachments of the distal MCL from the tibia requiring delayed surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

“…One of the few surgical indications for an acute repair or reconstruction of an isolated or concomitant MCL injury is an avulsion from the distal tibial insertion ( Fig 1 ). 4 , 9 , 10 , 11 , 12 When the distal insertion is ruptured, the MCL fibers can retract and displace superficial to the pes tendon, becoming a Stener-type lesion. Alternatively, the ligament can retract so much that it becomes incarcerated into the medial joint space.…”

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confidence: 99%

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Distal Knee Medial Collateral Ligament Repair With Suture Augmentation

Trofa

Sonnenfeld

Song

et al. 2018

Arthroscopy Techniques

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The medial collateral ligament (MCL) is the most commonly injured ligament of the knee. Given its extra-articular location, the MCL has great healing capacity such that the mainstay of treatment for most injuries remains conservative management. However, certain injury patterns place patients and athletes at risk of residual valgus laxity, which may require delayed surgical care and prolonged time out from sports. As such, identifying the specific injuries known to place patients at risk for failure with nonoperative management is of paramount importance. Although controversy remains regarding the optimal treatment of grade III MCL injuries, it is generally accepted that MCL ruptures from the distal tibia attachment require operative fixation. This technique article with accompanying video provides a detailed description of a technique for repairing the distal MCL attachment with suture augmentation. There are several advantages associated with an augmented direct repair including early, safe rehabilitation; prevention of valgus instability; and avoiding the comorbidities associated with a larger reconstruction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Distal Knee Medial Collateral Ligament Repair With Suture Augmentation

Trofa

Sonnenfeld

Song

et al. 2018

Arthroscopy Techniques

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“…Treatment of complete grade III injuries depends on whether the injuries are isolated or combined with other liga- 13 Surgery should be considered in certain circumstances: acute superficial MCL injuries in which the tibial insertion is displaced outside the pes anserinus tendons (Stener lesion), chronic laxity and instability after nonoperative treatment of isolated grade III injuries, multiligament injuries and knee dislocations, and some cases of MCL instability in the valgus aligned knee. Numerous reconstruction techniques exist for surgical treatment of grade III injuries, including combined repair and reconstruction, superficial MCL reconstructions, and MCL and POL reconstructions.…”

Section: Treatmentmentioning

confidence: 99%

Management of Medial-Sided Knee Injuries

Elliott¹,

Johnson²

2015

Orthopedics

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Medial collateral ligament injuries are common and are often associated with concomitant ligamentous, meniscus, and cartilage injuries. Orthopedic surgeons should be familiar with the outcomes of nonoperative and operative treatment of isolated and combined grade I, II, and III injuries. Special attention should be paid to identifying involvement of the posterior oblique ligament and capsule; lack of such attention may lead to failed nonoperative management. The authors present an overview of the treatment of medial-sided knee injuries, as well as 2 cases demonstrating their preferred method of treating chronic medial-sided laxity and instability.

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“…Surgery is recommended when injury is over the whole length of the superficial layer of the MCL or when there is injury to both the superficial and deep layers of the MCL. 17 18 19 …”

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confidence: 99%

Incidence, Positional Distribution, Severity, and Time Missed in Medial Collateral Ligament Injuries of the Knee in NCAA Division I Football Athletes

Motamedi¹,

Gowd

Nazemi

et al. 2017

JAAOS Glob Res Rev

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Introduction:We studied injury to the medial collateral ligament (MCL) in National Collegiate Athletic Association (NCAA) Division I football players, their incidence, magnitude of injury, distribution by position, and missed time, which has not previously been described in a consecutive series.Methods:The knee injuries sustained in 163 consecutive NCAA Division I collegiate football players at our institution were evaluated over a span of 6 years.Results:The incidence of MCL injuries with any knee injury was 29% (47 of 163). Of 47 MCL injuries, 34% occurred in defensive linemen and 29% in offensive linemen. The average days missed by linemen were 14.65 compared with 4.5 by nonlinemen (P = 0.07). The MCL injuries in linemen were more severe than nonlinemen (0.018).Discussion:MCL injuries occur most commonly in linemen in whom the magnitude of injury is also more significant than nonlinemen. Linemen miss more days than do nonlinemen to MCL injury.Study Design:Descriptive Epidemiology Study.

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Medial Collateral Ligament "Tibial" Injuries: Indication for Acute Repair

Abstract: Complete avulsions of the superficial and deep medial collateral ligament from the tibia with disruption of the meniscal coronary ligament should be managed with acute surgical repair for maximum benefit.

Cited by 42 publications

References 20 publications

Distal Knee Medial Collateral Ligament Repair With Suture Augmentation

Distal Knee Medial Collateral Ligament Repair With Suture Augmentation

Management of Medial-Sided Knee Injuries

Incidence, Positional Distribution, Severity, and Time Missed in Medial Collateral Ligament Injuries of the Knee in NCAA Division I Football Athletes

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