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A novel technique for combined medial collateral ligament and posterior oblique ligament reconstruction: technical note

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

In the last year, we have performed a new technique for combined medial collateral ligament (MCL) and posterior oblique ligament (POL) reconstruction in chronic setting of anterior cruciate ligament and MCL complex deficiency. Autogenous semitendinosus tendon with the tibial attachment preserved has been used for the medial/posteromedial compartment reconstruction. We describe the operative technique.

Methods

Between January and December 2014, 12 consecutive patients with multiligamentous injuries underwent concomitant MCL/POL using a novel technique. The usefulness of the novel technique is the semitendinosus sling on the semimembranosus tendon and the POL fixation with the knee in full extension.

Results

An ideal anteroposterior and rotational stability avoiding the medial compartment over constraint was achieved, in the immediate after surgery, due to the sequence of the bundle fixations and to the semitendinosus sling below the semimembranosus tendon.

Conclusions

This technique is easily reproducible and useful and restores the medial stability immediately after surgery.

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References

  1. Azar FM (2006) Evaluation and treatment of chronic medial collateral ligament injuries of the knee. Sports Med Arthrosc 14(2):84–90

    Article  PubMed  Google Scholar 

  2. Bauer KL, Stannard JP (2013) Surgical approach to the posteromedial corner: indications, technique, outcomes. Curr Rev Musculoskelet Med 6:124–131

    Article  PubMed Central  PubMed  Google Scholar 

  3. Jackson JB III, Ferguson CM, Martin DF (2006) Surgical treatment of chronic posteromedial instability using capsular procedures. Sports Med Arthrosc 14(2):91–95

    Article  Google Scholar 

  4. Bin SI, Nam TS (2007) Surgical outcome of 2-stage management of multiple knee ligament injuries after knee dislocation. Arthroscopy 23(10):1066–1072

    Article  PubMed  Google Scholar 

  5. Bonasia DE, Bruzzone M, Dettoni F, Marmotti A, Blonna D, Castoldi F, Gasparetto F, D’Elicio D, Collo G, Rossi R (2012) Treatment of medial and posteromedial knee instability: indications, techniques, and review of the results. Iowa Orthop J 32:173–183

    PubMed Central  CAS  PubMed  Google Scholar 

  6. Borden PS, Kantaras AT, Caborn DN (2002) Medial collateral ligament reconstruction with allograft using a double-bundle technique. Arthroscopy 18(4):E19

    Article  PubMed  Google Scholar 

  7. Coobs BR, Wijdicks CA, Armitage BM, Spiridonov SI, Westerhaus BD, Johansen S, Engebretsen L, Laprade RF (2010) An in vitro analysis of an anatomical medial knee reconstruction. Am J Sports Med 38(2):339–347

    Article  PubMed  Google Scholar 

  8. De Maeseneer M, Shahabpour M, Pouders C (2010) MRI spectrum of medial collateral ligament injuries and pitfalls in diagnosis. JBR-BTR 93(2):97–103

    PubMed  Google Scholar 

  9. Fanelli GC, Harris JD (2006) Surgical treatment of acute medial collateral ligament and posteromedial corner injuries of the knee. Sports Med Arthrosc 14(2):78–83

    Article  PubMed  Google Scholar 

  10. Fetto JF, Marshall JL (1978) Medial collateral ligament injuries of the knee: a rationale for treatment. Clin Orthop 132:206–218

    PubMed  Google Scholar 

  11. Griffith CJ, LaPrade RF, Johansen S, Armitage BM, Wijdicks CA, Engebresten L (2009) Medial knee injury: part 1, static function of the individual components of the main medial knee structures. Am J Sports Med 37(9):1762–1770

    Article  PubMed  Google Scholar 

  12. Inderhaug E, Strand T, Fischer-Bredenbeck C, Solheim E (2013) Long-term results after reconstruction of the ACL with hamstrings autograft and transtibial femoral drilling. Knee Surg Sports Traumatol Arthrosc 21(9):2004–2010

    Article  PubMed  Google Scholar 

  13. Jacobson KE, Chi FS (2006) Evaluation and treatment of medial collateral ligament and medial-sided injuries of the knee. Sports Med Arthrosc 14(2):58–66

    Article  PubMed  Google Scholar 

  14. Kim SJ, Lee DH, Kim TE, Choi NH (2008) Concomitant reconstruction of the medial collateral and posterior oblique ligaments for medial instability of the knee. J Bone Joint Surg Br 90(10):1323–1327

    Article  PubMed  Google Scholar 

  15. Rf Laprade, Engebretsen AH, Tv Ly, Johansen S, Wentorf FA, Engebretsen L (2007) The anatomy of the medial part of the knee. J Bone Joint Surg Am 89(9):2000–2010

    Article  Google Scholar 

  16. Lind M, Jakobsen BW, Lund B, Hansen MS, Abdallah O, Christiansen SE (2009) Anatomical reconstruction of the medial collateral ligament and posteromedial corner of the knee in patients with chronic medial collateral ligament instability. Am J Sports Med 37(6):1116–1122

    Article  PubMed  Google Scholar 

  17. Marchant MH Jr, Tibor LM, Sekiya JK, Hardaker WT Jr, Garrett WE Jr, Taylor DC (2011) Management of medial-sided knee injuries, Part 1: medial collateral ligament. Am J Sports Med 39(5):1102–1113

    Article  PubMed  Google Scholar 

  18. Papalia R, Osti L, Del Buono A, Denaro V, Maffulli N (2010) Management of combined ACL–MCL tears: a systematic review. Br Med Bull 93:201–215

    Article  PubMed  Google Scholar 

  19. Robinson JR, Sanchez-Ballester J, Bull AM, Thomas Rde W, Amis AA (2004) The posteromedial corner revisited: an anatomical description of the passive restraining structures of the medial aspect of the human knee. J Bone Joint Surg Br 86(5):674–681

    Article  CAS  PubMed  Google Scholar 

  20. Sims WF, Jacobson KE (2004) The posteromedial corner of the knee: medial-sided injury patterns revisited. Am J Sports Med 32(2):337–345

    Article  PubMed  Google Scholar 

  21. Stannard JP, Black BS, Azbell C, Volgas DA (2012) Posteromedial corner injury in knee dislocations. J Knee Surg 25(5):429–434

    Article  PubMed  Google Scholar 

  22. Stannard JP (2010) Medial and posteromedial instability of the knee: evaluation, treatment, and results. Sports Med Arthrosc 18(4):263–268

    Article  PubMed  Google Scholar 

  23. Tibor LM, Marchant MH Jr, Taylor DC, Hardaker WT Jr, Garrett WE Jr, Sekiya JK (2011) Management of medial-sided knee injuries, Part 2: posteromedial corner. Am J Sports Med 39(6):1332–1340

    Article  PubMed  Google Scholar 

  24. Wijdicks CA, Griffith CJ, Johansen S, Engebretsen L, Laprade RF (2010) Injuries to the medial collateral ligament and associated medial structures of the knee. J Bone Joint Surg Am 92(5):1266–1280

    Article  PubMed  Google Scholar 

  25. Yoshiya S, Kuroda R, Mizuno K, Yamamoto T, Kurosaka M (2005) Medial collateral ligament reconstruction using autogenous hamstring tendons: technique and results in initial cases. Am J Sports Med 33(9):1380–1385

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Ospedale Sacro Cuore Don Calabria, Via Don Angelo Sempreboni, 2-8, 37024, Negrar, VR, Italy

    V. Madonna, V. Condello, A. Russo & C. Zorzi

  2. University of Perugia, Piazza Università, 1, 06100, Perugia, PG, Italy

    D. Screpis

  3. University of Trieste, Piazzale Europa, 1, 34128, Trieste, TS, Italy

    G. Piovan

  4. Department of Computer Science, University of Verona, Via dell’Artigliere 8, 37129, Verona, VR, Italy

    M. Guerriero

Authors
  1. V. Madonna
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  2. D. Screpis
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  3. V. Condello
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  4. G. Piovan
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  5. A. Russo
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  6. M. Guerriero
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  7. C. Zorzi
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Corresponding author

Correspondence to V. Condello.

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Madonna, V., Screpis, D., Condello, V. et al. A novel technique for combined medial collateral ligament and posterior oblique ligament reconstruction: technical note. Knee Surg Sports Traumatol Arthrosc 23, 2814–2819 (2015). https://doi.org/10.1007/s00167-015-3721-6

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  • DOI: https://doi.org/10.1007/s00167-015-3721-6

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