A Novel Technique for Combined Medial Collateral Ligament and Posterior Oblique Ligament Reconstruction: Technical Note

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2015 Aug 3

PMID 26233595

Citations 8

Authors

V Madonna

D Screpis

V Condello

G Piovan

A Russo

M Guerriero

C Zorzi

Affiliations

Soon will be listed here.

Abstract

Purpose: In the last year, we have performed a new technique for combined medial collateral ligament (MCL) and posterior oblique ligament (POL) reconstruction in chronic setting of anterior cruciate ligament and MCL complex deficiency. Autogenous semitendinosus tendon with the tibial attachment preserved has been used for the medial/posteromedial compartment reconstruction. We describe the operative technique.

Methods: Between January and December 2014, 12 consecutive patients with multiligamentous injuries underwent concomitant MCL/POL using a novel technique. The usefulness of the novel technique is the semitendinosus sling on the semimembranosus tendon and the POL fixation with the knee in full extension.

Results: An ideal anteroposterior and rotational stability avoiding the medial compartment over constraint was achieved, in the immediate after surgery, due to the sequence of the bundle fixations and to the semitendinosus sling below the semimembranosus tendon.

Conclusions: This technique is easily reproducible and useful and restores the medial stability immediately after surgery.

Citing Articles

Total knee arthroplasty in Ranawat II valgus deformity with enlarged femoral valgus cut angle: A new technique to achieve balanced gap.

Lv S, Wang X, Huang J, Mao Q, He B, Tong P World J Clin Cases. 2022; 10(19):6406-6416.

PMID: 35979319 PMC: 9294892. DOI: 10.12998/wjcc.v10.i19.6406.

Midterm Outcomes, Complications, and Return to Sports After Medial Collateral Ligament and Posterior Oblique Ligament Reconstruction for Medial Knee Instability: A Systematic Review.

DAmbrosi R, Corona K, Guerra G, Cerciello S, Ursino N, Cavaignac E Orthop J Sports Med. 2021; 9(11):23259671211056070.

PMID: 34888393 PMC: 8649099. DOI: 10.1177/23259671211056070.

Posterior Oblique Ligament Repair Concomitant to Anterior Cruciate Ligament Reconstruction.

Rayes J, Fradin T, Ngbilo C, Clechet J, Vieira T, Cavaignac E Arthrosc Tech. 2021; 10(2):e551-e554.

PMID: 33680791 PMC: 7917300. DOI: 10.1016/j.eats.2020.10.037.

Weave Technique for Reconstruction of Medial Collateral Ligament and Posterior Oblique Ligament: An Anatomic Approach Using Semitendinosus Tendon.

Joshi A, Singh N, Thapa S, Pradhan I Arthrosc Tech. 2020; 8(11):e1417-e1423.

PMID: 31890516 PMC: 6926381. DOI: 10.1016/j.eats.2019.07.018.

Medial Collateral Ligament Reconstruction With Anteromedial Reinforcement for Medial and Anteromedial Rotatory Instability of the Knee.

Malinowski K, Hermanowicz K, Goralczyk A, LaPrade R Arthrosc Tech. 2019; 8(8):e807-e814.

PMID: 31700776 PMC: 6823834. DOI: 10.1016/j.eats.2019.03.019.

References

Yoshiya S, Kuroda R, Mizuno K, Yamamoto T, Kurosaka M . Medial collateral ligament reconstruction using autogenous hamstring tendons: technique and results in initial cases. Am J Sports Med. 2005; 33(9):1380-5. DOI: 10.1177/0363546504273487. View

Borden P, Kantaras A, Caborn D . Medial collateral ligament reconstruction with allograft using a double-bundle technique. Arthroscopy. 2002; 18(4):E19. DOI: 10.1053/jars.2002.32235. View

Stannard J, Black B, Azbell C, Volgas D . Posteromedial corner injury in knee dislocations. J Knee Surg. 2012; 25(5):429-34. DOI: 10.1055/s-0032-1322605. View

Bin S, Nam T . Surgical outcome of 2-stage management of multiple knee ligament injuries after knee dislocation. Arthroscopy. 2007; 23(10):1066-72. DOI: 10.1016/j.arthro.2007.05.008. View

Kim S, Lee D, Kim T, Choi N . Concomitant reconstruction of the medial collateral and posterior oblique ligaments for medial instability of the knee. J Bone Joint Surg Br. 2008; 90(10):1323-7. DOI: 10.1302/0301-620X.90B10.20781. View

Fanelli G, Harris J . Surgical treatment of acute medial collateral ligament and posteromedial corner injuries of the knee. Sports Med Arthrosc Rev. 2006; 14(2):78-83. DOI: 10.1097/01.jsa.0000212301.80496.dc. View

Papalia R, Osti L, Del Buono A, Denaro V, Maffulli N . Management of combined ACL-MCL tears: a systematic review. Br Med Bull. 2009; 93:201-15. DOI: 10.1093/bmb/ldp044. View

Sims W, Jacobson K . The posteromedial corner of the knee: medial-sided injury patterns revisited. Am J Sports Med. 2004; 32(2):337-45. DOI: 10.1177/0363546503261738. View

LaPrade R, Engebretsen A, Ly T, Johansen S, Wentorf F, Engebretsen L . The anatomy of the medial part of the knee. J Bone Joint Surg Am. 2007; 89(9):2000-10. DOI: 10.2106/JBJS.F.01176. View

10.

Bonasia D, Bruzzone M, Dettoni F, Marmotti A, Blonna D, Castoldi F . Treatment of medial and posteromedial knee instability: indications, techniques, and review of the results. Iowa Orthop J. 2013; 32:173-83. PMC: 3565399. View

11.

Wijdicks C, Griffith C, Johansen S, Engebretsen L, LaPrade R . Injuries to the medial collateral ligament and associated medial structures of the knee. J Bone Joint Surg Am. 2010; 92(5):1266-80. DOI: 10.2106/JBJS.I.01229. View

12.

Inderhaug E, Strand T, Fischer-Bredenbeck C, Solheim E . Long-term results after reconstruction of the ACL with hamstrings autograft and transtibial femoral drilling. Knee Surg Sports Traumatol Arthrosc. 2012; 21(9):2004-10. DOI: 10.1007/s00167-012-2330-x. View

13.

Fetto J, Marshall J . Medial collateral ligament injuries of the knee: a rationale for treatment. Clin Orthop Relat Res. 1978; (132):206-18. View

14.

Robinson J, Sanchez-Ballester J, Bull A, Thomas R, Amis A . The posteromedial corner revisited. An anatomical description of the passive restraining structures of the medial aspect of the human knee. J Bone Joint Surg Br. 2004; 86(5):674-81. DOI: 10.1302/0301-620x.86b5.14853. View

15.

Coobs B, Wijdicks C, Armitage B, Spiridonov S, Westerhaus B, Johansen S . An in vitro analysis of an anatomical medial knee reconstruction. Am J Sports Med. 2009; 38(2):339-47. DOI: 10.1177/0363546509347996. View

16.

Griffith C, LaPrade R, Johansen S, Armitage B, Wijdicks C, Engebretsen L . Medial knee injury: Part 1, static function of the individual components of the main medial knee structures. Am J Sports Med. 2009; 37(9):1762-70. DOI: 10.1177/0363546509333852. View

17.

Lind M, Jakobsen B, Lund B, Hansen M, Abdallah O, Christiansen S . Anatomical reconstruction of the medial collateral ligament and posteromedial corner of the knee in patients with chronic medial collateral ligament instability. Am J Sports Med. 2009; 37(6):1116-22. DOI: 10.1177/0363546509332498. View

18.

Azar F . Evaluation and treatment of chronic medial collateral ligament injuries of the knee. Sports Med Arthrosc Rev. 2006; 14(2):84-90. DOI: 10.1097/01.jsa.0000212311.77817.c8. View

19.

Bauer K, Stannard J . Surgical approach to the posteromedial corner: indications, technique, outcomes. Curr Rev Musculoskelet Med. 2013; 6(2):124-31. PMC: 3702774. DOI: 10.1007/s12178-013-9161-3. View

20.

De Maeseneer M, Shahabpour M, Pouders C . MRI spectrum of medial collateral ligament injuries and pitfalls in diagnosis. JBR-BTR. 2010; 93(2):97-103. DOI: 10.5334/jbr-btr.150. View