Blanke Fabian, Vonwehren Lutz, Pagenstert Geert, Valderrabano Victor, Majewski Martin
Acta Orthop Belg. 2015 Sep;81(3):442-6.
Combined lesions of anterior cruciate ligament (ACL) and medial collateral ligament (MCL) are frequent in athletes. While surgical treatment of ACL injury is mandatory treatment regime of concomitant grade II MCL lesions remains unclear with tendency to surgical intervention. Standardized surgical technique is lacking. Present study wants to introduce surgical technique for treatment of concomitant grade II MCL lesion and report short term outcome results. 5 Patients with acute ACL rupture and grade II MCL-lesion were included. All patients received surgical treatment of concomitant MCL lesion by distinct surgical technique and ACL reconstruction. We evaluated valgus instability, anterior instability and range of motion (ROM) according to international knee documentation commitee (IKDC) and Lysholm‑Score both preoperative and after 6, 16 weeks and 9 months postoperative. All Patients showed excellent clinical results at final follow-up. Valgus and anterior stability could be restored in all patients. 1 patient (20%) lost 15° in flexion of ROM at final follow up. However in all 5 patients (100%) the findings were graded as normal or nearly nor-mal according to IKDC knee examination form. Lysholm-Score averaged 94,6. Therefore presented surgical technique improved both, valgus and anterior stability, and led to excellent short term results at final follow up.
前交叉韧带（ACL）和内侧副韧带（MCL）联合损伤在运动员中很常见。虽然ACL损伤的手术治疗是必要的，但对于伴有II级MCL损伤的治疗方案仍不明确，存在手术干预的倾向。目前缺乏标准化的手术技术。本研究旨在介绍治疗伴有II级MCL损伤的手术技术，并报告短期结果。纳入了5例急性ACL断裂和II级MCL损伤的患者。所有患者均通过独特的手术技术对伴发的MCL损伤进行手术治疗并进行ACL重建。我们根据国际膝关节文献委员会（IKDC）和Lysholm评分在术前以及术后6周、16周和9个月评估外翻不稳定、前向不稳定和活动范围（ROM）。所有患者在最终随访时均显示出优异的临床结果。所有患者的外翻和前向稳定性均得以恢复。1例患者（20%）在最终随访时ROM屈曲度丢失15°。然而，根据IKDC膝关节检查表，所有5例患者（100%）的检查结果均被评为正常或接近正常。Lysholm评分平均为94.6。因此，所介绍的手术技术改善了外翻和前向稳定性，并在最终随访时取得了优异的短期结果。
