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

Artromedical Konrad Malinowski Clinic17 enrolled

Overview

The aim of this study is to assess the outcomes of the combined quadriceps tendon-bone (QTB) ACLR and MCLR with anteromedial reinforcement performed as described in the published technique: K. Malinowski, K. Hermanowicz, A. Góralczyk, R.F. LaPrade, Medial Collateral Ligament Reconstruction With Anteromedial Reinforcement for Medial and Anteromedial Rotatory Instability of the Knee, Arthrosc. Tech. 8 (2019) e807-e814. https://doi.org/10.1016/j.eats.2019.03.019.

Medial collateral ligament (MCL) injuries are one of the most common sports knee injuries, commonly occuring together with anterior cruciate ligament (ACL) injuries. Their effect on the knee joint can be detrimental with patients experiencing medial instability and anteromedial rotatory instability (AMRI), leading to progressive damage of the intraarticular structures. While healing potential of medial knee stabilizing structures is relatively high, medial collateral ligament reconstruction (MCLR) is sometimes indicated. Multiple reconstructions techniques were described, including both procedures utilizing native semitendinosus tendon with distal attachment left intact as well as with auto- or allo-grafts. However, in part of these techniques, AMRI is not addressed. Therefore, the aim of this study is to assess the outcomes of the combined quadriceps tendon-bone (QTB) ACLR and MCLR with anteromedial reinforcement performed as described in the published technique: K. Malinowski, K. Hermanowicz, A. Góralczyk, R.F. LaPrade, Medial Collateral Ligament Reconstruction With Anteromedial Reinforcement for Medial and Anteromedial Rotatory Instability of the Knee, Arthrosc. Tech. 8 (2019) e807-e814. https://doi.org/10.1016/j.eats.2019.03.019. The primary outcome consists of The International Knee Documentation Committee Questionnaire (IKDC) and the Knee injury and Osteoarthritis Outcome Score (KOOS).

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Interventions

Medial Collateral Ligament Reconstruction With Anteromedial ReinforcementPROCEDURE

Medial knee instabilities will be addressed in this arm as described in the published technique: K. Malinowski, K. Hermanowicz, A. Góralczyk, R.F. LaPrade, Medial Collateral Ligament Reconstruction With Anteromedial Reinforcement for Medial and Anteromedial Rotatory Instability of the Knee, Arthrosc. Tech. 8 (2019) e807-e814. https://doi.org/10.1016/j.eats.2019.03.019. Due to the fact that isolated injury of medial stabilizers of the knees is very rare, included will be patients with concomitant ACL QTB reconstruction and abovedescribed MCL reconstruction. Any accompanying intraarticular injuries such as meniscal lesions will be addressed as well.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Symptomatic knee medial and anteromedial rotatory instability associated with anterior and rotatory instability after an MCL + ACL injury * Primary cases Exclusion Criteria: * Active inflammation of the knee * Revision cases * Additional PLC, PCL or PFJ injuries * fractures around the knee * removal of more than ½ of medial or lateral meniscus * contralateral knee injury * cartilage damage ICRS grade III or higher * Non-adherence of the patient to the treatment protocol

Outcomes

Primary Outcomes

The functional assessment with the The International Knee Documentation Committee Questionnaire (IKDC)

Min of 0 max of 87 points, higher scores mean a better outcome

Time frame: Before the surgery

The functional assessment with the The International Knee Documentation Committee Questionnaire (IKDC)

Min of 0 max of 87 points, higher scores mean a better outcome

Time frame: At the 3 month of the follow-up.

The functional assessment with the The International Knee Documentation Committee Questionnaire (IKDC)

Min of 0 max of 87 points, higher scores mean a better outcome

Time frame: At the 6 month of the follow-up.

The functional assessment with the The International Knee Documentation Committee Questionnaire (IKDC)

Min of 0 max of 87 points, higher scores mean a better outcome

Time frame: At the 12 month of the follow-up.

The functional assessment with the The International Knee Documentation Committee Questionnaire (IKDC)

Min of 0 max of 87 points, higher scores mean a better outcome

Time frame: At the 24 month of the follow-up.

The functional assessment with the Knee injury and Osteoarthritis Outcome Score