Early surgical treatment for injury of posteromedial structure of the knee / 中国矫形外科杂志

ABSTRACT

[Objective]To discuss the postoperative effect of the posteromedial structure injury (medial collateral ligament,MCL,posterior oblique ligament,POL) of the knee.[Method]Fourteen cases of complex posteromedial structure injury were treated from January 2002 to October 2007,twelve of which combined with ACL injury and two combined with PCL injury.Classification of posteromedial structure injurytypeⅠ,8 cases,ruptured from the femur with small bone fragment;type Ⅱ,2 cases,ruptured from the femur without bone fragment;typeⅢ,2 cases,the structure were torn from the body area,and type Ⅳ,2 cases,ruptured from the tibia.The injury were repaired by different techniques according to the classification.Eight cases applied star-shaped steel plate,four with GⅡ anchor screws(2 attached to the femur and 2 to the tibia adhesion respectively),and 2 cases with end-to-end suture.The ruptured ACL and PCL were reconstructed by arthroscopy.Autologous semitendinosus and gracilis were used for 8 ACL reconstruction and B-T-B technique for the other two ACL reconstruction.Two ruptured PCL were reconstructed with allograft of Achilles tendon.[Result]All cases were followed up for twelve months at average(6-18 months) except two cases only for four months.The functional score of the knees were improved from 56.7(50-60) preoperatively to 81.2(74-94) postoperatively in average valued by Lysholm system.Ten cases received normal knee flexion and extension range after repair of the posteromedial structure while 2 cases with restricted 5 degree extension.Nine cases received excellent result in lateral stress test while 2 cases with "+" and 1 case with "++" at zero angle.[Conclusion]Early repaire for the posteromedial structure injury will deliver excellent knee stability.