Treatment of Combined Complete Tears of the Anterior Cruciate and Medial Collateral Ligaments

被引:62
作者
Grant, John A. [1 ]
Tannenbaum, Eric [2 ]
Miller, Bruce S. [1 ]
Bedi, Asheesh [1 ]
机构
[1] Univ Michigan, MedSport, Dept Orthopaed Surg, Ann Arbor, MI 48106 USA
[2] Univ Michigan, Fac Med, Ann Arbor, MI 48106 USA
关键词
NON-OPERATIVE TREATMENT; SIDED KNEE INJURIES; TERM FOLLOW-UP; NONOPERATIVE MANAGEMENT; COMBINED RUPTURES; FOOTBALL PLAYERS; RECONSTRUCTION; ACL; MOTION; PART;
D O I
10.1016/j.arthro.2011.08.293
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose: To develop an evidence-based algorithm for the treatment of combined complete tears of the anterior cruciate ligament (ACL) and medial collateral ligament (MCL). Methods: We performed a systematic review using computerized keyword searches of Medline, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), ACP Journal Club, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews. Two reviewers independently performed searches and article reduction. Studies that reported stratified outcomes data after the treatment of combined complete tears of the ACL and MCL were included. Data on clinical measures of laxity, range of motion, and strength, as well as subjective outcome measures, were summarized. Results: Five different treatment approaches were reported. Outcomes were better if the ACL was reconstructed and reconstruction was delayed to allow a return of knee range of motion. In many cases, this delay may allow the MCL to heal. MCL repair or reconstruction may be required if valgus instability remains after an appropriate rehabilitation period. Conclusions: ACL reconstruction should be performed in a subacute time frame once full motion has returned. Valgus instability should be assessed at that time and MCL repair or reconstruction performed in those patients with persistent valgus instability. Level of Evidence: Level IV, systematic review of Level I to IV studies.
引用
收藏
页码:110 / 122
页数:13
相关论文
共 48 条
[1]  
Aglietti P, 1991, AM J KNEE SURG, V4, P186
[2]   TREATMENT OF ACUTE ISOLATED AND COMBINED RUPTURES OF THE ANTERIOR CRUCIATE LIGAMENT - A LONG-TERM FOLLOW-UP-STUDY [J].
ANDERSSON, C ;
GILLQUIST, J .
AMERICAN JOURNAL OF SPORTS MEDICINE, 1992, 20 (01) :7-12
[3]   Evaluation and treatment of chronic medial collateral ligament injuries of the knee [J].
Azar, Frederick M. .
SPORTS MEDICINE AND ARTHROSCOPY REVIEW, 2006, 14 (02) :84-90
[4]   RECONSTRUCTION OF THE ANTERIOR CRUCIATE LIGAMENT ALONE IN THE TREATMENT OF A COMBINED INSTABILITY WITH COMPLETE RUPTURE OF THE MEDIAL COLLATERAL LIGAMENT - A PROSPECTIVE-STUDY [J].
BALLMER, PM ;
BALLMER, FT ;
JAKOB, RP .
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 1991, 110 (03) :139-141
[6]   A Stener-like Lesion of the Medial Collateral Ligament of the Knee [J].
Corten, Kristoff ;
Hoser, Christian ;
Fink, Christian ;
Bellemans, Johan .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2010, 468 (01) :289-293
[7]   NON-OPERATIVE TREATMENT OF COLLATERAL LIGAMENT INJURIES OF KNEE IN PROFESSIONAL FOOTBALL PLAYERS - ANALYSIS OF 74 INJURIES TREATED NON-OPERATIVELY AND 24 INJURIES TREATED SURGICALLY [J].
ELLSASSER, JC ;
REYNOLDS, FC ;
OMOHUNDRO, JR .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1974, A 56 (06) :1185-1190
[8]  
FETTO JF, 1978, CLIN ORTHOP RELAT R, P206
[9]  
fibresowler PJ., 1991, AM J SPORTS MED, V19, P624
[10]   Primary reconstruction of the medial collateral ligament in combined injury of the medial collateral and anterior cruciate ligaments: Short-term results [J].
Frölke J.P.M. ;
Oskam J. ;
Vierhout P.A.M. .
Knee Surgery, Sports Traumatology, Arthroscopy, 1998, 6 (2) :103-106