Results of Two-Stage Operative Treatment of Anteromedial Instability of the Knee

Piątkowski, Krzysztof; Płomiński, Janusz; Sowiński, Tomasz; Piekarczyk, Piotr; Kwiatkowski, Krzysztof; Gołos, Justyna

doi:10.5604/15093492.1097487

Cited by 7 publications

(4 citation statements)

References 34 publications

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“…The same study reported a mean Lysholm score of 94.5, an ACL stability side-to-side difference of 2.3 mm and no valgus or rotational instability at follow-up. Nakamura et al [31] compared MCL reconstruction versus conservative MCL treatment in combination with ACL knee injuries and found no between-group differences in subjective or objective (valgus laxity) outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…According to the American Medical Association classification [2], MCL injuries can be divided into three categories (grades I–III) according to the level of medial structural injury and valgus laxity. Grade III MCL injuries often present in combination with ACL tears [1, 31]. A recent epidemiological study on knee injuries among 17,397 patients with 19,530 sports‐related injuries over a 10‐year period found 7.9% of isolated MCL lesions [23].…”

Section: Introductionmentioning

confidence: 99%

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Medial collateral ligament (MCL) reconstruction results in improved medial stability: results from the Danish knee ligament reconstruction registry (DKRR)

Lind

Nielsen

2019

Knee Surg Sports Traumatol Arthrosc

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Purpose The aim of this study was to compare outcome data after isolated and combined (MCL) plus anterior cruciate ligament (ACL) reconstruction based on objective and subjective measures using data from the (DKRR). There are only a few small-sized case studies on outcomes after MCL reconstruction. MCL reconstruction was hypothesised to improve both objective and subjective outcomes. Methods All patients who were registered in the DKRR between 2005 and 2016 (N = 25,281) and who underwent isolated ACL (n = 24,683), isolated MCL (n = 103) or combined MCL plus ACL (n = 495) reconstructions were retrospectively identified. Objective (valgus knee stability and sagittal knee laxity) and subjective (Knee Injury and Osteoarthritis Outcome Score (KOOS) and Tegner activity scale score) outcomes in these three cohorts were evaluated at the 1-year follow-up by comparing pre-and post-operative values. Results Medial stability improved significantly pre-to post-operatively after both isolated MCL and combined MCL plus ACL reconstruction, with 26 (53%) and 195 (69%) of the patients, respectively, having normal valgus stability (0-2 mm laxity). Sagittal stability was similar after MCL plus ACL reconstruction and isolated ACL reconstruction (1.7 and 1.5 mm, respectively). At the 1-year follow-up, although the KOOS of the patients in the isolated MCL and combined MCL plus ACL reconstruction cohorts improved significantly, they were lower than those of the patients in the isolated ACL reconstruction cohort. Conclusion Both isolated MCL reconstruction and combined MCL plus ACL reconstruction resulted in significant and clinically relevant improvements in the subjective outcomes from pre-operative conditions to the 1-year follow-up. Valgus stability also improved significantly, with two-thirds of patients obtaining normal valgus stability after MCL reconstruction. Subjective outcomes were similar between isolated MCL reconstruction and combined MCL plus ACL reconstructions, but were poorer than isolated ACL reconstructions. Level of evidence Level III.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Medial collateral ligament (MCL) reconstruction results in improved medial stability: results from the Danish knee ligament reconstruction registry (DKRR)

Lind

Nielsen

2019

Knee Surg Sports Traumatol Arthrosc

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“…Osteoarthritis of the knee is defined as a set of changes involving articular cartilage damage, abnormal bone formation, reactive changes in the synovial membrane, and pathologic synovial fluid [1]. It has recently become an important public health issue, the frequency of which is increasing day by day, due to the aging population all over the world as well as in Türkiye, the increased prevalence of obesity, and the rapid world population growth.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Early-Mid-Term Results of Isolated Tibial Insert Exchange After Total Knee Arthroplasty

Eke¹,

Akçal²

2023

Cureus

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Objective: This study aimed to assess the early and mid-term results of patients who had undergone total knee arthroplasty (TKA) and then underwent an isolated tibial insert exchange due to tibial insert fracture and/or melting.Methods: A retrospective study was conducted at the Orthopedics and Traumatology Clinic in a secondarycare public hospital in Türkiye on seven knees of six patients aged 65 years and above who underwent an isolated tibial insert exchange and were followed up for at least six months. Pain and functional assessments of the patients were made with the visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) performed at the last control before the treatment and at the final follow-up visit after the treatment.Results: The median age of the patients was 70.5 years. The median length of time between the primary TKA and the isolated tibial insert exchange was 5.96 years. After isolated tibial insert exchange, the patients were followed for a median of 268 days and a mean of 414 days. The WOMAC pain, stiffness, function, and total indexes were median 15, 2, 52, and 68, respectively, before the treatment. In contrast, the final follow-up WOMAC pain, stiffness, function, and total indexes were median 3 (p = 0.01), 1 (p = 0.023), 12 (p = 0.018), and 15 (p = 0.018), respectively. It was observed that the median VAS, which was "9" preoperatively, showed a statistically significant improvement to become "2" in the postoperative period. A strong negative correlation was found between age and the amount of decline in the total score of the WOMAC pain scale (r = -0.780; p = 0.039). There was a powerful negative correlation between the body mass index (BMI) and the amount of decline in WOMAC pain scores (r = -0.889; p = 0.007). A strong negative correlation was found between the length of time passing between two surgical procedures and the amount of decline in the WOMAC pain score (r = -0.796; p = 0.032).Conclusion: Individual patient factors and prosthetic conditions should be considered undoubtedly when determining the best revision strategy in TKA patients. In cases where the components are well-aligned and well-fixed, isolated tibial insert exchange is an alternative to revision TKA since it is less invasive and more cost-effective.Categories: Pain Management, Orthopedics Keywords: western ontario and mcmaster universities arthritis index (womac), isolated tibial insert exchange, visual analogue scale (vas), tka (total knee arthoplasty), persistent knee pain, knee function

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“…TCM recognizes that the knee joint relies on various structures, including bones, tendons, ligaments, and cartilage, to facilitate movement and support the body. [1] Wind is considered to be the cause of around a hundred diseases in TCM and can cause havoc by moving pain from joint to joint. External pathogenic factors such as cold can also enter the body and cause severe pain, especially in the knee joint.…”

Section: Introductionmentioning

confidence: 99%

Traditional Chinese Medicine in Gonarthrosis

Zhu¹,

Arsovska²,

Kozovska³

2023

oaijoaru

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Gonarthrosis is a degenerative joint disease that is typically characterized by the gradual loss of articular cartilage in the knee joint. It is also associated with other changes such as abnormal bone formation, reactive changes in the synovial membrane, and pathologic synovial fluid. Acupuncture and fire needle acupuncture are a traditional Chinese medicine (TCM) techniques that can significantly help in treating of gonarthrosis, particularly in reducing pain and improving physical function. Both acupuncture and fire needle acupuncture have anti-inflammatory effects that can help to alleviate pain and reduce inflammation in the knee joint. In this article is presented a case of 62 year old woman with a main complaint of chronic knee pain due to gonarthrosis. Patient had this problem for more than two years. After 7 treatments, with a combination of acupuncture and fire needle acupuncture once weekly, the patient have reported improvements in selfassessment of pain using the Visual Analog Scale (VAS) score of 2 out of 10. The selected acupuncture points are: ST 35 (Du bi), ST 36 (Zu san li), ST 34 (Liang qiu), SP 10 (Xuehai), GB 34 (Yang ling quan), SP6 (San yin jiao). Fire needling was done on Ashi points i.e. trigger points found on places where the pain is most dominant or where the place is obviously inflamed. In addition to pain relief, the patient also reported an improvement in the physical function.

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Results of Two-Stage Operative Treatment of Anteromedial Instability of the Knee

Cited by 7 publications

References 34 publications

Medial collateral ligament (MCL) reconstruction results in improved medial stability: results from the Danish knee ligament reconstruction registry (DKRR)

Medial collateral ligament (MCL) reconstruction results in improved medial stability: results from the Danish knee ligament reconstruction registry (DKRR)

Evaluation of the Early-Mid-Term Results of Isolated Tibial Insert Exchange After Total Knee Arthroplasty

Traditional Chinese Medicine in Gonarthrosis

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