Jacob George, A N Sukesh, Kumar Gautham, Varghese Jacob
VPS Lakeshore Hospital, Kochi, India.
Arthrosc Tech. 2020 Sep 25;9(10):e1511-e1517. doi: 10.1016/j.eats.2020.06.014. eCollection 2020 Oct.
Medial collateral ligament (MCL) injuries are commonly encountered alongside anterior cruciate ligament injuries. Treatment modalities have ranged from conservative management to surgical repair, augmentation, and reconstruction. Various reports have reported residual valgus instability, especially in higher-grade injuries that have been treated conservatively. The MCL provides valgus stability but also is an element of anterior stability to the tibia in addition to the anterior cruciate ligament. In addition, meniscal "lift-off" and "floating" have been described as consequences after MCL injuries, and meniscal dysfunction has been shown to lead to accelerated joint degeneration; therefore, all efforts should be made to treat these injuries adequately. We describe a simple, minimally invasive technique that involves suturing the deep MCL to the medial joint capsule, allowing better MCL healing, causing less soft-tissue scarring, and preventing meniscal extrusion.
内侧副韧带(MCL)损伤常与前交叉韧带损伤同时出现。治疗方式从保守治疗到手术修复、增强和重建不等。各种报告都报道了残留的外翻不稳定,尤其是在接受保守治疗的高级别损伤中。MCL提供外翻稳定性,但除了前交叉韧带外,它也是胫骨前向稳定性的一个要素。此外,半月板“抬起”和“漂浮”已被描述为MCL损伤后的后果,并且半月板功能障碍已被证明会导致关节加速退变;因此,应尽一切努力充分治疗这些损伤。我们描述了一种简单的微创技术,该技术包括将深层MCL缝合到内侧关节囊,可使MCL更好地愈合,减少软组织瘢痕形成,并防止半月板挤出。