Anatomic medial knee reconstruction restores stability and f
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Chronic grade 3 tears of the medial collateral ligament and posterior oblique ligament may result in valgus laxity and anteromedial rotational instability after an isolated or multiligament injury. The purpose of this study was to prospectively analyze the restoration of physiologic medial laxity as assessed on stress radiography and patient reported subjective functional outcomes in patients who undergo an anatomic medial knee reconstruction which achieves stability in 2 years.

34 patients (23 males, 11 females) were enrolled in the study and all were available till final follow-up of mean 49.7±14.9 months. The mean age was 30.6±7.9 (18–52 years). This was a prospective study which included patients with chronic (more than 6 weeks old) posteromedial corner injury with or without other ligament and meniscus lesions. Pre- and post-operative valgus stress radiographs were performed in 20° knee flexion and functional outcome was recorded as per the International Knee Documentation Committee (IKDC) and Lysholm scores. All patients underwent anatomic medial reconstruction with two femoral and two tibial sockets using ipsilateral hamstring tendon autograft. Simultaneous ligament and meniscus surgery was performed as per the associated injury pattern. All patients were followed up for a minimum of 24 months post-surgery.

Results:
--2 patients had isolated medial sided lesions and 23 had associated ligament injuries. The mean follow up was 49.7 months.

--The mean IKDC score improved from 58±8.3 to 78.2±9.5.

--Post-operatively there were 15 excellent, 11 good and 8 fair outcomes on Lysholm score.

--The mean pre-operative valgus side-to-side opening improved from 7.5±2.5 mm to 1.2±0.7 mm on stress radiography.

In particular, anatomical repair of the superficial medial collateral and posterior oblique ligaments restores the integrity of chronic grade 3 instability in a consistent manner. Objective functional effects, subjective findings and static medial stabilisation steps are adequate in the short term.

Source: https://link.springer.com/article/10.1007/s00167-021-06502-1
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