The exclusive autograft choice for medial collateral ligament (MCL) reconstruction that has been described until today is the semitendinosus tendon. However, this has some potential disadvantages in a knee with combined MCL-anterior cruciate ligament (ACL) injury, including weakening of the hamstring's anterior restraining action in an already ACL-injured knee and nonanatomic distal MCL graft insertion when leaving the semitendinosus insertion intact at the pes anserinus during reconstruction. Moreover, because some surgeons prefer to use the hamstring for autologous ACL reconstruction, the contralateral uninjured knee hamstring needs to be harvested as a graft source for the MCL reconstruction if autografts and not allografts are the surgeons' preference. We describe a technique for performing combined reconstruction of the MCL and ACL using ipsilateral quadriceps tendon-bone and bone-patellar tendon-bone autografts. This technique of MCL reconstruction spares the hamstring tendons and benefits from the advantage provided by bone-to-bone healing on the femur with distal and proximal MCL tibial fixation that closely reproduces the native MCL tibia insertion.
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http://dx.doi.org/10.1016/j.eats.2016.02.021 | DOI Listing |
J ISAKOS
December 2024
Twin Cities Orthopedics, Edina, Minnesota, USA. Electronic address:
Medial meniscus ramp tears are tears of the posteromedial capsule or peripheral rim of the posteromedial meniscus that frequently occur with anterior cruciate ligament (ACL) tears. The incidence and prevalence of medial meniscus ramp tears has been increasing in the recent literature due to the increased understanding of the anatomy and diagnosis of these tears. When a patient presents with an ACL tear, a medial meniscus ramp tear should be suspected if the patient has a grade 3+ Lachman or pivot shift exam, a vertical line of increased signal intensity in the posterior capsule or peripheral meniscus on magnetic resonance imagining (MRI), or posteromedial tibial plateau bone bruising on MRI.
View Article and Find Full Text PDFArthroscopy
December 2024
Orthopaedic Surgery Department - Aker, Oslo University Hospital, Oslo, Norway; University of Oslo, Oslo, Norway; Oslo Sports trauma research Center, Norwegian School of Sports Sciences, Oslo, Norway. Electronic address:
Background: The co-occurrence of anterior cruciate ligament (ACL) rupture with medial collateral ligament (MCL) rupture is a compound injury that can be associated with meniscal tears.
Purpose: To report the characteristics of meniscal tears in knees with isolated ACL versus combined ACL and MCL injuries, analyzing their frequency, distribution by site, and lesion type.
Study Design: Cross-sectional study; Level of evidence, 3.
Arch Orthop Trauma Surg
December 2024
Sporthopaedicum Regensburg, Regensburg, Germany.
Purpose: Varus posteromedial rotatory instability (VPMRI) involves anteromedial coronoid fracture (AMCF), lateral ulnar collateral ligament (LUCL), and medial collateral ligament (MCL) injury. There is no general consensus regarding the surgical treatment, but most surgeons recommend internal fixation of the coronoid along with primary ligament repair. This methodology involves postoperative immobilization to allow ligament healing, occasionally associated with stiffness.
View Article and Find Full Text PDFOrthop J Sports Med
December 2024
Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
Background: Several types of suture anchors, which differ in their working principles, are available for fixation of ligamentous structures in knee surgery. How the choice of a suture anchor type influences the biomechanical stability of ligament fixation is largely unknown.
Purpose: To compare the biomechanical properties of different suture anchor designs regarding primary stability for tendon fixation and repair in medial collateral ligament (MCL) surgery.
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