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Return to Sports after Acute Simultaneous Reconstruction of Anterior Cruciate Ligament Injury and Grade III Medial Collateral Ligament Injury
OBJECTIVES: Combined Anterior Cruciate Ligament (ACL) injury and Medial Collateral Ligament (MCL) injury account for 20% of knee ligament lesions. Conservative treatment of MCL and surgical ACL reconstruction are generally recommended. Significant medial instability after non-surgical management of...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5318819/ http://dx.doi.org/10.1177/2325967117S00031 |
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author | Bertona, Agustin Zicaro, Juan Pablo Viescas, Juan Manuel Gonzalez Atala, Nicolas Yacuzzi, Carlos Costa-Paz, Matias |
author_facet | Bertona, Agustin Zicaro, Juan Pablo Viescas, Juan Manuel Gonzalez Atala, Nicolas Yacuzzi, Carlos Costa-Paz, Matias |
author_sort | Bertona, Agustin |
collection | PubMed |
description | OBJECTIVES: Combined Anterior Cruciate Ligament (ACL) injury and Medial Collateral Ligament (MCL) injury account for 20% of knee ligament lesions. Conservative treatment of MCL and surgical ACL reconstruction are generally recommended. Significant medial instability after non-surgical management of MCL can lead to ACL reconstruction failure. The optimal management for athletes with combined ACL-MCL injuries remains controversial. The purpose of this study was to analyze the functional and clinical evolution of patients who underwent combined ACL-MCL surgery and their return-to-sport level with minimum 2-years follow-up. METHODS: A total of 20 athletes with acute simultaneous ACL/Grade III MCL reconstructions were treated between March 2006 and January 2014. The minimum follow-up time was 24 months. Subjective functional results (IKDC, Lysholm), range of motion, anterior-medial and rotational stability (Lachmann, Pivot Shift, valgus stress) were evaluated. The ability to return to sport (Tegner) and the level achieved was recorded. RESULTS: All patients significantly improved functional scores and stability tests. The mean subjective IKDC score improved from 37.7 ± 12.9 (range 21-69) preoperatively to 88.21 ± 4.47 (range 80-96) postoperatively (P <0.05). The average Lysholm score was 40.44 ± 10.58 (range 27-65) preoperatively and 90.83 ± 3.38 (range 84-95) postoperatively (P <0.05). Valgus and sagittal laxity was not observed (IKDC A 92% B 8%) at final follow-up. All patients had normal/nearly normal (IKDC A or B) mobility. All patients returned to sports; 90% reached the level they had prior to the ligamentous injury. Of all competitive athletes, 66% achieved the same level of sport. CONCLUSION: In athletes with acute ACL-Grade III MCL lesions, an early simultaneous reconstruction can significantly improve the medial and sagittal stability of the knee. This procedure resulted in excellent functional outcomes, with return to the same level of sports in the majority of patients at short-term follow-up. |
format | Online Article Text |
id | pubmed-5318819 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-53188192017-03-01 Return to Sports after Acute Simultaneous Reconstruction of Anterior Cruciate Ligament Injury and Grade III Medial Collateral Ligament Injury Bertona, Agustin Zicaro, Juan Pablo Viescas, Juan Manuel Gonzalez Atala, Nicolas Yacuzzi, Carlos Costa-Paz, Matias Orthop J Sports Med Article OBJECTIVES: Combined Anterior Cruciate Ligament (ACL) injury and Medial Collateral Ligament (MCL) injury account for 20% of knee ligament lesions. Conservative treatment of MCL and surgical ACL reconstruction are generally recommended. Significant medial instability after non-surgical management of MCL can lead to ACL reconstruction failure. The optimal management for athletes with combined ACL-MCL injuries remains controversial. The purpose of this study was to analyze the functional and clinical evolution of patients who underwent combined ACL-MCL surgery and their return-to-sport level with minimum 2-years follow-up. METHODS: A total of 20 athletes with acute simultaneous ACL/Grade III MCL reconstructions were treated between March 2006 and January 2014. The minimum follow-up time was 24 months. Subjective functional results (IKDC, Lysholm), range of motion, anterior-medial and rotational stability (Lachmann, Pivot Shift, valgus stress) were evaluated. The ability to return to sport (Tegner) and the level achieved was recorded. RESULTS: All patients significantly improved functional scores and stability tests. The mean subjective IKDC score improved from 37.7 ± 12.9 (range 21-69) preoperatively to 88.21 ± 4.47 (range 80-96) postoperatively (P <0.05). The average Lysholm score was 40.44 ± 10.58 (range 27-65) preoperatively and 90.83 ± 3.38 (range 84-95) postoperatively (P <0.05). Valgus and sagittal laxity was not observed (IKDC A 92% B 8%) at final follow-up. All patients had normal/nearly normal (IKDC A or B) mobility. All patients returned to sports; 90% reached the level they had prior to the ligamentous injury. Of all competitive athletes, 66% achieved the same level of sport. CONCLUSION: In athletes with acute ACL-Grade III MCL lesions, an early simultaneous reconstruction can significantly improve the medial and sagittal stability of the knee. This procedure resulted in excellent functional outcomes, with return to the same level of sports in the majority of patients at short-term follow-up. SAGE Publications 2017-01-31 /pmc/articles/PMC5318819/ http://dx.doi.org/10.1177/2325967117S00031 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc-nd/3.0/ This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For reprints and permission queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav. |
spellingShingle | Article Bertona, Agustin Zicaro, Juan Pablo Viescas, Juan Manuel Gonzalez Atala, Nicolas Yacuzzi, Carlos Costa-Paz, Matias Return to Sports after Acute Simultaneous Reconstruction of Anterior Cruciate Ligament Injury and Grade III Medial Collateral Ligament Injury |
title | Return to Sports after Acute Simultaneous Reconstruction of Anterior Cruciate Ligament Injury and Grade III Medial Collateral Ligament Injury |
title_full | Return to Sports after Acute Simultaneous Reconstruction of Anterior Cruciate Ligament Injury and Grade III Medial Collateral Ligament Injury |
title_fullStr | Return to Sports after Acute Simultaneous Reconstruction of Anterior Cruciate Ligament Injury and Grade III Medial Collateral Ligament Injury |
title_full_unstemmed | Return to Sports after Acute Simultaneous Reconstruction of Anterior Cruciate Ligament Injury and Grade III Medial Collateral Ligament Injury |
title_short | Return to Sports after Acute Simultaneous Reconstruction of Anterior Cruciate Ligament Injury and Grade III Medial Collateral Ligament Injury |
title_sort | return to sports after acute simultaneous reconstruction of anterior cruciate ligament injury and grade iii medial collateral ligament injury |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5318819/ http://dx.doi.org/10.1177/2325967117S00031 |
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