Summary
In a prospective study, 14 patients with a complete rupture of both the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL) were treated by reconstruction of the ACL alone. The torn MCL was not addressed. The initial instability was documented clinically and by stress radiographs (20 kp) taken under anaesthesia. The postoperative management involved immediate mobilization and partial weight bearing for 6–8 weeks. Follow-up examination at an average of 14 months demonstrated excellent results in 11 cases, good in 2 cases, and fair in 1 case. With the exception of one residual anterior tibial translation of 8 mm, all knees showed almost normal stability in the frontal and sagittal plane, with full range of motion. These result confirm that ACL reconstruction utilizing the patellar tendon alone is sufficient in the treatment of combined instability due to ACL and MCL injuries.
Zusammenfassung
In einer prospektiven Studie wurde bei 14 Patienten mit einer vollständigen Ruptur des vorderen Kreuzbandes (VKB) und medialen Seitenbandes (MSB) lediglich eine VKB-Rekonstruktion vorgenommen. Die initiale Gelenkinstabilität beurteilte man in Periduralanästhesie ergänzt durch Streßröntgenaufnahmen (20 kp). Alle Kniegelenke wurden frühfunktionell nachbehandelt mit Teilbelastung während den ersten 6–8 Wochen. Die Nachkontrolle nach durchschnittlich 14 Monaten ergab in 11 Fällen ein sehr gutes, in 2 Fällen ein gutes und in 1 Fall ein mäßiges Endresultat. Außer einer residuellen vorderen Tibiatranslation von 8 mm waren alle Kniegelenke in der Frontal- und Sagittalebene stabil. Die praktisch durchwegs guten Ergebnisse zeigen, daß der alleinige VKB-Ersatz mit der Patellarsehne bei Kombinationsverletzungen genügt, um eine korrekte Ausheilung der unversorgten MSB-Läsion zu gewährleisten.
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Ballmer, P.M., Ballmer, F.T. & Jakob, R.P. Reconstruction of the anterior cruciate ligament alone in the treatment of a combined instability with complete rupture of the medial collateral ligament. Arch Orthop Trauma Surg 110, 139–141 (1991). https://doi.org/10.1007/BF00395795
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DOI: https://doi.org/10.1007/BF00395795