Management of Acute Combined Injuries of the Medial Supporting Structures and Anterior Cruciate Ligament of the Knee

ABSTRACT

PURPOSE: We introduce the management protocol of medial structures-ACL combined injury patients in Asan Medical Center and evaluate the results of the management according to severity of medial injuries. MATERIALS AND METHODS: From Jan.1994 to May 1998, we treated 30 cases of acute combined injuries of medial structures and ACL. Unless the medial structures shows grade IIIwithout end point, we man-aged the medial structures conservatively and conducted ACL reconstuction . After that, we analysed the results of the management. Evaluation was based on the Lysholm knee scoring system, physical examina-tion and stress radiographs. RESULTS: The functional result by Lysholm knee scoring revealed 92.4/95.3(medial structures conserva-tive / repair groups) respectively. Except 1 case of persistent medial laxity in medial structures repair group, there was no severe complication in both groups. CONCLUSIONS: There was no significant medial laxity after conservative management in grade I,II,III with end point injury of medial supporting structures and we had good results in severe medial injury involving MCL, posterior oblique ligament in terms of ROM and stability with open repair of medial structures and delayed arthroscopic ACL reconstruction.