Non-operative treatment of complete tears of the medial collateral ligament of the knee.

Publisher Website
Google Scholar
Abstract
A prospective study was designed to compare the results of operative and nonoperative treatment of complete (grade-III) isolated tears of the medial collateral ligament of the knee. For 18 consecutive mo., all patients suspected of having this injury were examined under anesthesia and arthroscopically before primary surgical repair was performed. At the time of surgery, the preoperative diagnosis was confirmed in all knees. Surgery was followed by a 6-wk period of immobilization of the knee in a plaster cast and a well defined supervised rehabilitation program. These patients comprised group I. For the ensuing 18 mo., all patients with this injury of the medial collateral ligament were also examined under anesthesia and by arthroscopy but were treated by immobilization of the knee in a plaster cast for 2 wk, the use of a cast-brace for 4 wk, and the same rehabilitation program was used in group I. These patients comprised group II. Patients (16) in group I were followed for an average of 3.1 yr and 20 patients in group II for an average of 2.4 yr. In both groups, examination under anesthesia and arthroscopic evaluation of the intraarticular structures demonstrated that there was no structural damage to the anterior cruciate ligament, menisci or articular surfaces. Patients (15 of 16) in group I and patients (17 of 20) in group II had a good or excellent result. Primary surgical repair of a complete (grade-III) isolated tear of the medial collateral ligament apparently is not necessarily indicated. Rehabilitation was expedited in the patients who were treated with cast-bracing alone, since these patients regained their strength as measured by the Cybex-II machine, in significantly (P > 0.001) less time (group I, 14.9 .+-. 1.5 wk and group II, 11.3 .+-. 1.8 wk). The key to success in the treatment of this injury is to establish that there is an isolated lesion with no associated damage to other vital structures, particularly the anterior cruciate ligament and the menisci.

This publication has 0 references indexed in Scilit: