Operative Techniques in Sports Medicine
Volume 11, Issue 4 , Pages 248-256, October 2003

Surgical treatment of ACL/PCL/ medial-side knee injuries

  • Frederick M Azar, MD

      Affiliations

    • Corresponding Author InformationAddress reprint requests to Frederick M. Azar, University of Tennessee-Campbell Clinic, Department of Orthopedic Surgery, 910 Madison Avenue, Suite 500, Memphis, TN 38103, USA
    • University of Tennessee-Campbell Clinic, Department of Orthopedic Surgery, Memphis, TN, USA

Abstract 

The medial cruciate ligament (MCL), anterior cruciate ligament (ACL), and posterior oblique ligament (POL) frequently are injured by a combination of valgus and external rotation forces. Grade I or II MCL injuries alone or in combination with ACL or posterior cruciate ligament (PCL) injuries are treated nonoperatively, with cruciate ligament reconstruction delayed 3 to 6 weeks. Treatment of acute grade III ACL/PCL medial knee injuries remains controversial. Recommendations have included nonoperative treatment of the MCL and reconstruction of the ACL and PCL, acute reconstruction of the MCL and nonoperative treatment of the ACL, and treatment of all grade III injuries with acute repair. For chronic ACL/PCL/medial knee injuries, magnetic resonance imaging and examination under anesthesia are followed by endoscopic ACL/PCL reconstruction. Severe valgus laxity usually requires tightening of the MCL in addition to the posterior capsule, the posterior oblique area of the posteromedial capsule, and the midmedial capsular ligament. Thorough preoperative planning is essential to determine what procedures will be necessary for each patient.

Keywords:  Cruciate ligaments, posterior oblique ligament, combined injuries, treatment, surgical technique

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PII: S1060-1872(03)00048-0

doi:10.1016/S1060-1872(03)00048-0

Operative Techniques in Sports Medicine
Volume 11, Issue 4 , Pages 248-256, October 2003

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