Archives of orthopaedic and traumatic surgery

, Volume 107, Issue 5, pp 273–276

The non operative treatment of isolated complete tears of the medial collateral ligament of the knee

A Prospective Study
  • P. M. Ballmer
  • R. P. Jakob
Original Articles

Summary

In a prospective randomized study, 20 patients with isolated grade-III injuries to the medial collateral ligament (MCL) of the knee were treated by two different conservative methods: immediate mobilization (group A) or plaster immobilization (group B). All patients were examined while under anesthesia. Valgus-stress radiographs were performed to document a 2+ opening (6–10mm) on the medial side. Associcated damage to other structures (cruciate ligaments, menisci, cartilage) was ruled out arthroscopically. Average follow-up was 1.5 years. All patients rated good or excellent, although a minimal laxity of 3 mm on valgus-stress radiographs was present in 60% of the cases. No significant differences between the two treatment modalities were identified, except that group-A patients returned to work sooner. These results confirm that isolated grade-III MCL tears can be treated successfully by immediate mobilization.

Zusammenfassung

In einer prospektiven randomisierten Studie wurden zwei konservative Behandlungsverfahren (funktionelle Therapie und Gipsimmobilisation) bei 20 Patienten mit einer isolierten medialen Seitenbandverletzung Grad III des Kniegelenkes verglichen. Die initiale Gelenksstabilität beurteilte man in Periduralanästhesie ergänzt durch Valgusstressröntgenaufnahmen. Begleitverletzungen (Kreuzbänder, Menisci und Knorpel) wurden arthroskopisch ausgeschlossen. Die Nachkontrolle erfolgte nach durchschnittlich 1,5 Jahren. Alle Patienten wiesen ein gutes bis sehr gutes Endergebnis auf, obwohl in 60% eine minimale Restinstabilität (mediale Auf klappbarkeit bis zu 3 mm) nachweisbar war. Zwischen den beiden Gruppen bestand kein signifikanter Stabilitätsunterschied. Nach funktioneller Nachbehandlung war jedoch eine 30% frühere Arbeitsaufnahme möglich. Unsere erfolgreichen Ergebnisse berechtigen somit eine frühfunktionelle Nachbehandlung der isolierten, vollständigen Verletzung des medialen Seitenbandkomplexes.

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Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • P. M. Ballmer
    • 1
  • R. P. Jakob
    • 1
  1. 1.Department of Orthopedic SurgeryUniversity of BerneBerneSwitzerland

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