The effects of transection of the anterior cruciate ligament on healing of the medial collateral ligament. A biomechanical study of the knee in dogs.

Woo, Savio L‐Y.; Young, Edmond P; Ohland, Karen J.; Marcin, J. P.; Horibe, Shuji; Lin, Hong‐Ping

doi:10.2106/00004623-199072030-00010

Cited by 93 publications

(58 citation statements)

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“…While clinical experience has shown that isolated MCL injuries can heal with closed treatment (Indelicato 1983, 1995, Kannus 1988, Indelicato et al 1990), the results on healing of the MCL in a combined ACL and MCL injury have not been encouraging (Woo et al 1990). Some authors have recommended acute treatment of all damaged structures, others have reported a high incidence of arthrofibrosis with this method (Shelbourne and Baele 1988).…”

mentioning

confidence: 99%

Interaction between the ACL graft and MCL in a combined ACL+MCL knee injury using a goat model

Benjamin

Papageogiou

Debski

et al. 2000

Acta Orthopaedica Scandinavica

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mentioning

confidence: 99%

Interaction between the ACL graft and MCL in a combined ACL+MCL knee injury using a goat model

Benjamin

Papageogiou

Debski

et al. 2000

Acta Orthopaedica Scandinavica

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“…Basic investigations have repeatedly shown extreme degradation and loss of mechanical integrity in multiple tissues of the knee engendered by joint laxity (2,3,6,23,24). The deterioration of secondary restraining capsular and ligamentous structures after loss of the anterior cruciate ligament has been demonstrated in dogs, rabbits, and rats (2)(3)(4)12,15,21,23,24). The results of these investigations, in the aggregate, generally support the concept that ligaments show gradual meReceived October 10,1996; accepted September 29,1997.…”

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confidence: 99%

Physiological and mechanical adaptations of rabbit medial collateral ligament after anterior cruciate ligament transection

Bray

Doschak

Gross

et al. 1997

Journal Orthopaedic Research

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Progressive physiological and mechanical changes in the medial collateral ligament of the adult rabbit were investigated for as long as 48 weeks after disruption of the anterior cruciate ligament. Eighty-one New Zealand White rabbits were separated into experimental, sham-operated control, and normal control groups. The experimental group underwent unilateral transection of the right anterior cruciate ligament, sham-operated animals served as controls for comparison, and normal animals were evaluated as age-matched, undisturbed (no surgery) controls. Blood flow to the medial collateral ligament (as a physiological measure) and mechanical function (structural and material properties) were assessed at 6, 14, and 48 weeks. The results indicated that loss of the anterior cruciate ligament leads to early mechanical deterioration of the medial collateral ligament with a corresponding loss of physiological homeostasis. Six to 14 weeks after the transection, values for cross-sectional area of the medial collateral ligaments rapidly increased to 1.5 times control values. The ligament became twice as large as the control ligament by 48 weeks. Concomitantly, medial collateral ligament stress at failure of the medial collateral ligament complex decreased rapidly 6-14 weeks after the transection and eventually fell to one-half that of controls by 48 weeks. In terms of low-load behaviour, laxity and load relaxation were significantly greater than that of controls 6 weeks after transection and were further increased by 14 weeks. By 48 weeks, laxity values had recovered somewhat and load-relaxation measures had recovered to near control values. At both 6 and 14 weeks, a statistically significant elevation in blood flow was demonstrated compared with controls. By 48 weeks, however, blood flow was no different from that of the sham-operated control. Thus, early after transection of the anterior cruciate ligament, both low-load and high-load mechanical properties of the medial collateral ligament deteriorated and the rate of blood flow was temporarily elevated. By 48 weeks, blood flow declined to near control values, with a corresponding recovery in viscoelastic behaviour. These findings suggest that, after transection of the anterior cruciate ligament, viscoelastic behaviour of the medial collateral ligament may be related to changes in blood flow and that restoration of normal flow patterns and vascular responses may be linked to the recovery of some low-load mechanical properties in the anterior cruciate ligament-deficient medial collateral ligament.

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“…La técnica quirúrgica a utilizar en la lesión del LCM es un tema de debate (8,16,17,21,(33)(34)(35)(36) . La reconstrucción del LCM utilizando injerto autólogo de isquiotibiales ha sido reportada con buenos resultados funcionales en pacientes con lesiones crónicas del LCM.…”

Section: Discussionunclassified

“…Múltiples autores consideran que el tratamiento aislado del LCA en lesiones asociadas de LCA y LCM es suficiente para restaurar la estabilidad de la rodilla (13)(14)(15) . Sin embargo, existe evidencia de que en lesiones asociadas de LCA y LCM de grado III, la reparación aislada del LCA se relaciona con mayor carga mecánica sobre el LCA reconstruido, aumentando el riesgo de falla y de inestabilidad crónica sintomática en valgo de la rodilla (16)(17)(18) . La reconstrucción simultánea de LCA y LCM en lesiones asociadas ha sido descrita con buenos resultados funcionales (8,19,20) .…”

Section: Introductionunclassified

Retorno al deporte posterior a una reconstrucción simultánea de ligamento cruzado anterior y ligamento colateral medial de grado III en periodo subagudo

Bertona¹,

Zicaro²,

González-Viescas³

et al. 2018

REACA

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RESUMENIntroducción: las lesiones asociadas del ligamento cruzado anterior (LCA) y del ligamento colateral medial (LCM) corresponden al 20% de la lesiones ligamentosas de la rodilla. El tratamiento conservador del LCM y la reconstrucción quirúrgica del LCA son generalmente recomendados. En deportistas, el tratamiento conservador del LCM puede conducir a inestabilidad medial crónica. El manejo óptimo de deportistas con lesiones combinadas de LCA-LCM continúa siendo controvertido. El objetivo de este trabajo es analizar los resultados funcionales y el nivel deportivo alcanzado en el postoperatorio de una serie de pacientes tratados con reconstrucción simultanea de LCA y LCM con un seguimiento mínimo de 2 años. Material y métodos: un total de 20 atletas con reconstrucciones agudas simultáneas de LCA y LCM de grado III fueron tratados entre marzo de 2006 y enero de 2014. El tiempo mínimo de seguimiento fue de 24 meses. Se evaluaron los resultados funcionales subjetivos (International Knee Documentation Committee -IKDC-, Lysholm), rango de movilidad, estabilidad anteromedial y rotacional (Lachmann, pivot shift, estrés valgo). Se registró la capacidad de retorno al deporte (Tegner) y el nivel alcanzado. ABSTRACT IntroducciónEl ligamento colateral medial (LCM) es la estructura ligamentosa de la rodilla más frecuentemente lesionada (1) . Anatómicamente se diferencia en LCM superficial (LCMs), LCM profundo (LCMp) y ligamento posterior oblicuo (LPO) (2) . Dependiendo del porcentaje de compromiso ligamentoso y la inestabilidad medial de la rodilla, las lesiones del LCM se dividen en los grados I, II y III, correspondiendo las lesiones de grado III a la disrupción completa de las fibras ligamentosas (3) . Las lesiones de grado III están asociadas a otras lesiones ligamentosas en el 80% de los casos. De estas lesiones asociadas, el 95% corresponde a lesiones del ligamento cruzado anterior (LCA) (4) . El mecanismo de lesión implica la carga en valgo de la rodilla, rotación externa o un vector de fuerza combinado que requiere la flexión de la rodilla (5)(6)(7) . El manejo de las lesiones de LCM depende del grado del compromiso ligamentoso. En lesiones asiladas de grado I y II el tratamiento no quirúr-gico, con rehabilitación funcional precoz, es ampliamente aceptado. En lesiones de LCM de grado III, especialmente en asociación con lesión de LCA, el tratamiento es controvertido (8)(9)(10)(11)(12) . Múltiples autores consideran que el tratamiento aislado del LCA en lesiones asociadas de LCA y LCM es suficiente para restaurar la estabilidad de la rodilla (13)(14)(15) . Sin embargo, existe evidencia de que en lesiones asociadas de LCA y LCM de grado III, la reparación aislada del LCA se relaciona con mayor carga mecánica sobre el LCA reconstruido, aumentando el riesgo de falla y de inestabilidad crónica sintomática en valgo de la rodilla (16)(17)(18) . La reconstrucción simultánea de LCA y LCM en lesiones asociadas ha sido descrita con buenos resultados funcionales (8,19,20) . Resultados: todos los pacientes mejoraron significat...

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The effects of transection of the anterior cruciate ligament on healing of the medial collateral ligament. A biomechanical study of the knee in dogs.

Cited by 93 publications

References 0 publications

Interaction between the ACL graft and MCL in a combined ACL+MCL knee injury using a goat model

Interaction between the ACL graft and MCL in a combined ACL+MCL knee injury using a goat model

Physiological and mechanical adaptations of rabbit medial collateral ligament after anterior cruciate ligament transection

Retorno al deporte posterior a una reconstrucción simultánea de ligamento cruzado anterior y ligamento colateral medial de grado III en periodo subagudo

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