ABSTRACT
Objectives: This study aimed to introduce a novel arthroscopic treatment for medial and posteromedial instability of the knee and present the primary and follow-up results. Methods: All patients who underwent the arthroscopic approach to treat medial and posteromedial corner instability from 2007 to 2017 were included in this report. Overall, 45 patients were included, among which 75.6% were male. The mean age of patients was 32.2 ± 8.4 years. Overall, 44.4% and 15.6% of patients had associated meniscal injuries and chondral lesions, respectively. The mean follow-up duration of patients was 84.2 ± 25.3 months. Results: Overall, 37 patients developed a full range of motion (82.2%), and most patients (95.6%) showed excellent quadriceps strength (grades 4 and 5). All patients had a normal or 1+ posterior drawer test, Pivot shift test, and Lachman test on physical examination. Moreover, 60% had an associated isolated anterior cruciate ligament injury, 17.8% had an isolated posterior collateral ligament injury, and 17.6% had a combination of more than one ligament injury. One patient developed septic arthritis. Two patients experienced pain, and one pain patient developed pain with a bony spur formation in the medial epicondyle. Three patients showed a 2+ medial collateral ligament (MCL) test (moderate instability) at the final follow-up, all of whom had multi-ligament injuries. All patients, except the three patients who had a failed MCL reconstruction, returned to their previous activities. Conclusion: This study described a novel arthroscopic treatment of MCL injury, and the results showed acceptable postoperative and clinical outcomes. As the use of minimally invasive surgery may minimize multiple complications associated with open surgery, it is suggested that further studies be conducted regarding this approach when faced with patients who have MCL injuries requiring surgery.
ABSTRACT
PURPOSE: We evaluated and compared kinematics of bilateral ankle, knee, and hip joints in patients with chronic unilateral ankle instability (CAI) with healthy controls. METHODS: Fifteen individuals diagnosed with CAI and a control group of 16 individuals were matched. Different peaks within the gait cycle (at different intervals) for the dorsiplantar, inversion/eversion, and abduction/adduction axis were compared between injured and uninjured sides of patients with CAI with a control group. RESULTS: Comparison of the uninjured ankle in CAI with the control group showed higher dorsiflexion in one peak of the stance phase (p = 0.003), higher inversion in one peak of the stance phase (p = 0.022), and the swing phase (p = 0.004). The hip joint of the uninjured side showed higher extension in one peak of the stance phase (p < 0.001), and two peaks of the swing phase (p < 0.05). Furthermore, it showed higher adduction in one peak of the foot flat to mid-stance phase (p = 0.001), higher abduction in one peak of the late swing phase (p = 0.047), and the swing phase (p = 0.032). The knee joint of the uninjured side showed higher flexion in all measured peaks of the gait cycle (p < 0.05) (except for one peak in the late swing phase) compared to the control group. CONCLUSION: Chronic ankle instability results in altered biomechanics of the ipsilateral knee as well as the contralateral ankle, knee, and hip joints. The alterations caused by CAI may predispose patients to overuse and/or acute injuries of other joints of lower extremities during routine and sporting activity.
