Clinical and Radiological Evaluation of Detached MCL cases in Medial Release During TKA: MCL detached vs stable CR vs stable PS

ABSTRACT

PURPOSE: On performing TKA in severe varus deformity, sometimes processing medial release, we can not get well balanced knee without completely detaching the MCL in tibial attached site. In these cases, we analyzed the clinical and radiological results. MATERIALS AND METHODS: We evaluated 20 TKA patients with completely detached MCL (Group I) comparing to 20 TKA patients without MCL detached using CR type(Group II), 20 TKA patients without MCL detaches using PS type(Group III). The clinical evaluation was done by the American Knee Society evaluation system. The radiographic examination in valgus stress were done with Telos device under control of fluoroscopic guide 0 degree and 30 degree flexion. RESULTS: The mean knee score of each group was improved from 43, 45, and 41 points preoperatively to 89, 90, and 91, then mean functional score also improved from 52, 54, and 57 points preoperatively to 88, 91 and 94 points at the latest follow-up respectively. On the radiographs in valgus stress at 0 degree flexion and 30 degree flexion, the mean angle were; in group I 4.5 and 6.0 degree, in group II 3.1 and 4.2 degree, in group III 3.4 and 4.7 degree. There was no patients to complain the subjective medial instability of the knee. CONCLUSION: On performing TKA in severe varus deformity, in releasing MCL, it might be detached completely from tibial side. In this situation, this resulted in good function and there was no need to reattach the ligament and use constrained type prosthesis.