Reconstruction of the medial ligament complex of the knee for chronic anteromedial instability using a modification of the Nicolas procedure

Reconstruction of the medial ligament of the knee for chronic anteromedial instability possesses a major problem. Lots of methods and varieties of techniques were described. Hey Grove in 1917 described an operation for reconstruction of the Anterior Cruciate Ligament using the ilio-tibial band. In 1920, he expanded the technique to include reconstruction of the tibial collateral ligament. Slocum and Larson in 1968 described transfer of the pes ansencrius tendons. Opinions varied whether to attack the femoral attachment of the ligament [Augustine 1956 and Nicolas 1974] or the tibial attachment of the ligament [Mauck 1936 and O'Donoghue 1973]. However, no technique proved to be satisfactory. None was able to restore a ligament with proper isometric attachment which, in our opinion is the major cause of failure. In this paper we are presenting our experience with a rather new technique which is based on the principles used by Nicholas in 1973

Result of surgical repair of acute medial ligament complex of the knee

Fourty two cases were the subject of repair for acute medial ligament injuries. Twenty five cases [59.5%] were rated as excellent, thirteen [30.9%] as good and four [9.5%] as poor. Repair or reconstruction of a concomitant cruciate injury should be attempted to at the same time: a peripherally detached meniscus should be sutured and preserved