Zaffagnini Stefano, Bignozzi Simone, Martelli Sandra, Lopomo Nicola, Marcacci Maurilio
Laboratorio di Biomeccanica, Istituti Ortopedici Rizzoli, Bologna, Italy.
Clin Orthop Relat Res. 2007 Jan;454:95-9. doi: 10.1097/BLO.0b013e31802b4a86.
Treating anterior cruciate ligament (ACL) lesions combined with a torn medial collateral ligament (MCL) is controversial because residual laxity may lead to stretching of the ACL graft and eventual failure of the reconstruction. Few studies describe the in vivo translations of combined ACL and MCL injuries. We compared the preoperative and postoperative laxity between patients with combined ACL+MCL Grade II injuries and isolated ACL ruptures and tested whether an ACL reconstruction could restore all laxities in both groups. We evaluated knee kinematics during ACL reconstruction in 57 patients (37 ACL lesions and 20 ACL+MCL injury). Laxity tests were performed before and after graft fixation. Postoperatively, there was greater anteroposterior laxity and greater varus-valgus laxity in the group with MCL injury compared to the group with an ACL lesion only. This finding suggests residual laxities remain when ACL reconstruction is performed in patients with combined ACL+MCL lesion, and raises the question of addressing the MCL ligament when Grade II laxity is found.
治疗前交叉韧带（ACL）损伤合并内侧副韧带（MCL）撕裂存在争议，因为残余松弛可能导致ACL移植物拉伸并最终导致重建失败。很少有研究描述ACL和MCL联合损伤的体内移位情况。我们比较了ACL+MCL II级联合损伤患者与孤立ACL断裂患者术前和术后的松弛情况，并测试了ACL重建是否能恢复两组的所有松弛情况。我们评估了57例患者（37例ACL损伤和20例ACL+MCL损伤）在ACL重建过程中的膝关节运动学。在移植物固定前后进行松弛测试。术后，与仅患有ACL损伤的组相比，患有MCL损伤的组有更大的前后松弛和更大的内翻-外翻松弛。这一发现表明，在ACL+MCL联合损伤患者中进行ACL重建时仍存在残余松弛，并提出了在发现II级松弛时处理MCL韧带的问题。
