Abstract
Anteromedial knee injury with rupture of anterior cruciate ligament (ACL) and concomitant
lesion of medial collateral ligament (MCL) is common in athletes. No standardized
treatment concept can be found within the literature. This study presents results
of a new treatment concept for concomitant MCL lesions in patients with ACL rupture.
In this study, 67 recreational athletes with ACL injury and concomitant MCL lesion
were treated according to a distinct treatment concept. Patients were classified in
six different types of concomitant MCL lesion depending on grade of MCL lesion and
presence of anteromedial rotatory instability (AMRI). Final classification and surgical
indication were determined 6 weeks posttraumatic. All patients received ACL reconstruction.
MCL was treated by surgical or conservative regime due to type of concomitant MCL
lesion. International Knee Documentation Committee (IKDC), AMRI, and Lysholm scores
were evaluated both preoperatively and after 6 weeks, 16 weeks, 12 months, and 18
months postoperatively. All patients could be uniquely classified and treated according
to the introduced treatment concept. AMRI was verifiable in patients with grade II
and III MCL lesions. All patients showed good to excellent clinical results at the
follow-up examinations. In all 67 patients (100%), the findings were graded as normal
or nearly normal according to the IKDC knee examination form. Lysholm score averaged
93.9 at final follow-up. The introduced treatment concept showed good results on short-term
outcome and provides a sufficient treatment strategy for concomitant MCL lesions in
athletes with ACL rupture.
Keywords
anterior cruciate ligament - medial collateral ligament - AMRI - treatment concept
