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Clinical outcomes of medial collateral ligament injury in total knee arthroplasty.

Abstract Intraoperative injury to the medial collateral ligament (MCL) during total knee arthroplasty (TKA) is a rare but severe complication. The main treatment methods are primary repair and revision with a more constrained implant; however, the clinical outcomes of primary reconstruction without a constrained implant have rarely been reported.A retrospective study was performed to evaluate the prevalence of iatrogenic injury to the MCL during primary TKA, and to report the clinical outcomes of MCL reconstruction without the use of a constrained device.A total of 1749 patients (2054 knees) underwent primary TKA between 2007 and 2013 and were retrospectively evaluated. Seventeen patients (0.83%) experienced an MCL injury intraoperatively, and the remaining 1732 patients (2037 knees) were considered as the controls. We attempted to reconstruct the MCL with an unconstrained prosthesis in all patients. The Knee Society Score (KSS) was used to evaluate knee function after an average 51-month follow-up (range, 36-72 months).No patients were lost during the follow-up period. In the MCL injury group, the mean KSS was 84.7 for function and 87.7 for pain, while the scores were 87.9 and 90.6, respectively, in the control group. No patient treated with MCL reconstruction without increased prosthetic constraint experienced knee instability requiring revision.MCL reconstruction without a constrained implant achieved excellent results for MCL injury during TKA.
PMID
Related Publications

SEMITENDINOUS AND GRACILIS TRANSFER FOR TREATMENT OF MEDIAL COLLATERAL LIGAMENT INJURY CAUSED BY TOTAL KNEE ARTHROPLASTY.

Outcomes of Medial Collateral Ligament Injuries during Total Knee Arthroplasty.

Primary Repair of Iatrogenic Medial Collateral Ligament Injury During TKA: A Modified Technique.

Repair of Intraoperative Injury to the Medial Collateral Ligament During Primary Total Knee Arthroplasty.

Management of intraoperative medial collateral ligament injury during TKA.

Authors

Mayor MeshTerms

Reconstructive Surgical Procedures

Keywords
Journal Title medicine
Publication Year Start




PMID- 28746219
OWN - NLM
STAT- MEDLINE
DA  - 20170726
DCOM- 20170807
LR  - 20170807
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 30
DP  - 2017 Jul
TI  - Clinical outcomes of medial collateral ligament injury in total knee
      arthroplasty.
PG  - e7617
LID - 10.1097/MD.0000000000007617 [doi]
AB  - Intraoperative injury to the medial collateral ligament (MCL) during total knee
      arthroplasty (TKA) is a rare but severe complication. The main treatment methods 
      are primary repair and revision with a more constrained implant; however, the
      clinical outcomes of primary reconstruction without a constrained implant have
      rarely been reported.A retrospective study was performed to evaluate the
      prevalence of iatrogenic injury to the MCL during primary TKA, and to report the 
      clinical outcomes of MCL reconstruction without the use of a constrained device.A
      total of 1749 patients (2054 knees) underwent primary TKA between 2007 and 2013
      and were retrospectively evaluated. Seventeen patients (0.83%) experienced an MCL
      injury intraoperatively, and the remaining 1732 patients (2037 knees) were
      considered as the controls. We attempted to reconstruct the MCL with an
      unconstrained prosthesis in all patients. The Knee Society Score (KSS) was used
      to evaluate knee function after an average 51-month follow-up (range, 36-72
      months).No patients were lost during the follow-up period. In the MCL injury
      group, the mean KSS was 84.7 for function and 87.7 for pain, while the scores
      were 87.9 and 90.6, respectively, in the control group. No patient treated with
      MCL reconstruction without increased prosthetic constraint experienced knee
      instability requiring revision.MCL reconstruction without a constrained implant
      achieved excellent results for MCL injury during TKA. LEVEL OF EVIDENCE: Level
      IV, therapeutic study.
FAU - Wang, Xiaomeng
AU  - Wang X
AD  - The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
FAU - Liu, Huixin
AU  - Liu H
FAU - Cao, Pengkai
AU  - Cao P
FAU - Liu, Chang
AU  - Liu C
FAU - Dong, Zhenyue
AU  - Dong Z
FAU - Qi, Jianchao
AU  - Qi J
FAU - Wang, Fei
AU  - Wang F
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Aged
MH  - Arthroplasty, Replacement, Knee/*adverse effects
MH  - Collateral Ligaments/*injuries/*surgery
MH  - Comorbidity
MH  - Female
MH  - Follow-Up Studies
MH  - Hamstring Tendons/transplantation
MH  - Humans
MH  - Intraoperative Complications/epidemiology/*rehabilitation/*surgery
MH  - Male
MH  - Middle Aged
MH  - Pain Measurement
MH  - Prevalence
MH  - Range of Motion, Articular
MH  - *Reconstructive Surgical Procedures
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Treatment Outcome
EDAT- 2017/07/27 06:00
MHDA- 2017/08/08 06:00
CRDT- 2017/07/27 06:00
AID - 10.1097/MD.0000000000007617 [doi]
AID - 00005792-201707280-00050 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(30):e7617. doi: 10.1097/MD.0000000000007617.