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J Knee Surg 2023; 36(11): 1164-1170
DOI: 10.1055/s-0042-1749609
Original Article

Analysis of Health-Related Quality of Life and Clinical Evaluations in Patients with the Triad of Combined Knee Injuries

Satoshi Ochiai 
1   The Sports Medicine and Knee Center, National Hospital Organization, Kofu National Hospital, Kofu, Yamanashi, Japan
,
Tetsuo Hagino
1   The Sports Medicine and Knee Center, National Hospital Organization, Kofu National Hospital, Kofu, Yamanashi, Japan
,
Shinya Senga
1   The Sports Medicine and Knee Center, National Hospital Organization, Kofu National Hospital, Kofu, Yamanashi, Japan
,
Takashi Yamashita
1   The Sports Medicine and Knee Center, National Hospital Organization, Kofu National Hospital, Kofu, Yamanashi, Japan
,
Takashi Ando
2   Department of Orthopaedic Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
,
Naofumi Taniguchi
2   Department of Orthopaedic Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
,
Hirotaka Haro
2   Department of Orthopaedic Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
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Abstract

Combined knee injuries of the anterior cruciate ligament (ACL), medial collateral ligament (MCL), and medial meniscus were called “the unhappy triad” in the past. With recent advances in diagnostic technology, combined ACL, MCL, and lateral meniscus injuries are now known to be the predominant triad. We examined and verified the treatment outcomes of the triad of combined knee injuries from both patient-based subjective evaluation and objective assessments. We studied 49 knees (49 patients) with combined injuries of the ACL, MCL, and lateral meniscus. These cases were divided into those who underwent simultaneous ACL and MCL reconstruction (group A, 18 cases) and those who underwent ACL reconstruction only because MCL injury could be treated conservatively (group B, 31 cases). Clinical evaluation was conducted preoperative and 24 months or longer after surgery. The methods included patient-reported outcomes using Short Form-36, and conventional assessments using Lysholm's score, visual analogue scale (VAS), and quantitative measurement of knee instability using Telos SE. Compared with presurgical scores, the postsurgical Short Form-36 scores showed improvements in all eight subscales, all reaching the national standard values. Significant improvements were observed in the five subscales in group A and seven subscales in group B. Furthermore, significant improvements in Lysholm's score, VAS pain score, and quantitative knee instability were achieved in both groups. This study demonstrated successful clinical outcomes in patients with a triad of knee injuries who were treated with lateral meniscus repair or partial meniscectomy and either combined MCL/ACL reconstruction or ACL reconstruction alone.

Keywords

unhappy triad - combined knee injuries - Short Form-36 - treatment outcome

Availability of Data and Materials

All data and materials were in the compliance with the journal's policy fully.


Authors' Contributions

S.O. designed and prepared the manuscript. S.S., T.Y., N.T., and T.A. collected and analyzed research data. T.H. and H.H. interpreted research data and edited the manuscript. All authors read and approved the final manuscript.




Publication History

Received: 11 June 2020

Accepted: 26 April 2022

Article published online:
11 July 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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