Cameron J C, Saha S
Orthopaedic and Arthritic Hospital, Toronto, Ontario, Canada.
Orthop Clin North Am. 1994 Jul;25(3):527-32.
Assessment of axial alignment with 3-foot radiographs and valgus-varus stress radiographs is important when managing symptomatic MCL instability. Realignment of the anatomical axis to 0 degrees to reduce the stress on the MCL reduces the symptomatic laxity. The assessment of MCL laxity is important when considering valgus HTO for medial compartment arthritis. A combined opening and closing wedge osteotomy reduces the size of the fragment needed and tensions the MCL at the same time. Interposition proximal tibial allografts may be used to retention combined MCL/LCL laxity as well as to correct associated deformities. As one would expect, defunctioning of the MCL in patients with valgus is best achieved using a varus distal femoral osteotomy.
在处理有症状的内侧副韧带（MCL）不稳定时，通过3英尺位X线片和内外翻应力X线片评估轴向对线情况很重要。将解剖轴重新调整至0度以减轻MCL上的应力，可减轻症状性松弛。在考虑针对内侧间室关节炎进行外翻高位胫骨截骨术（HTO）时，评估MCL松弛情况很重要。联合开放和闭合楔形截骨术可减少所需骨块的大小，同时拉紧MCL。胫骨近端异体骨植入可用于保留合并的MCL/LCL松弛以及纠正相关畸形。正如人们所预期的，对于外翻患者，通过股骨远端内翻截骨术能最好地实现MCL功能丧失。
