Department of Orthopaedic Surgery, College of Medicine, Hanyang University, Seoul, South Korea.
J Arthroplasty. 2009 Dec;24(8):1249-53. doi: 10.1016/j.arth.2009.06.007. Epub 2009 Jul 28.
For intraoperative injuries of the medial collateral ligament (MCL) during primary total knee arthroplasty (TKA), many authors recommended complex reconstructive procedures or conversion to the constrained prosthesis in previous literature. However, it is well known that medial collateral ligament has good healing potential after injuries. This retrospective study evaluated the clinical and radiological results of 15 primary TKAs complicated with intraoperative complete detachment of the MCL from tibial attachment site, which were all treated solely by nonoperative conservative treatment without any other additive procedures or braces. Compared to the MCL-intact contralateral knees, there was no significant difference in terms of clinical and radiological outcome at minimum of 2 postoperative year. There was no case showing clinical instability, either. Solely, the nonoperative conservative treatment for intraoperative injuries of the MCL during primary TKAs is expected not only to be effective with satisfactory results but also to decrease complications derived from other sophisticated reparative or reconstructive procedures.
在初次全膝关节置换术中，内侧副韧带（MCL）发生术中损伤的情况并不少见，既往文献中许多作者建议采用复杂的重建手术或改为限制性假体。然而，众所周知，MCL 在受伤后具有良好的愈合潜力。本回顾性研究评估了 15 例初次 TKA 术中发生 MCL 从胫骨附着点完全撕脱的病例，所有病例均仅采用非手术保守治疗，未采用任何附加手术或支具。与 MCL 完整的对侧膝关节相比，至少 2 年的术后随访时两组的临床和影像学结果无显著差异。也没有出现临床不稳定的病例。初次 TKA 术中 MCL 损伤的单纯非手术保守治疗不仅有效，而且结果令人满意，同时还降低了因其他复杂修复或重建手术带来的并发症。
