Stephens Scott, Politi Joel, Backes Jeffrey, Czaplicki Tony
Mount Carmel Hospital System, Columbus, Ohio, USA.
Orthopedics. 2012 Feb 17;35(2):e154-9. doi: 10.3928/01477447-20120123-01.
Intraoperative midsubstance lacerations of the medial collateral ligament (MCL) must be addressed during surgery, and failure to obtain coronal plane stability could affect patient outcomes and satisfaction. This article reports our results of a series of patients who sustained an intraoperative MCL injury during a primary total knee arthroplasty and were treated by direct primary repair and no change in implant constraint or postoperative protocol. Over a 5-year period, 9 patients sustained this complication. We reviewed their subjective satisfaction and stability, as well as objective measures such as functional scores, physical examinations, and radiographs. Average patient age was 58 years, and mean patient body mass index was 43.3. All patients were satisfied with the procedure and demonstrated no instability on physical examination. Average Knee Society pain score was 91.5 and functional score was 73.3. No radiographic changes or signs of loosening were noted. This novel approach for intraoperative midsubstance lacerations of the MCL does not involve altering implants or postoperative protocols and has encouraging results.
术中内侧副韧带（MCL）实质中部撕裂在手术过程中必须得到处理，未能获得冠状面稳定性可能会影响患者的治疗效果和满意度。本文报告了一系列在初次全膝关节置换术中发生术中MCL损伤并接受直接一期修复且植入物限制或术后方案未改变的患者的治疗结果。在5年期间，有9名患者出现了这种并发症。我们评估了他们的主观满意度和稳定性，以及功能评分、体格检查和X线片等客观指标。患者平均年龄为58岁，平均体重指数为43.3。所有患者对手术均满意，体格检查未发现不稳定情况。膝关节协会平均疼痛评分为91.5，功能评分为73.3。未发现X线片改变或松动迹象。这种针对术中MCL实质中部撕裂的新方法不涉及改变植入物或术后方案，且取得了令人鼓舞的结果。
