采用异体跟腱实施浅表内侧副韧带重建术以治疗多重韧带受损膝盖的亚急性和慢性外翻足不稳定：至少随访2年的定量分析

Sports Medicine Service, Beijing Jishuitan Hospital, Xinjiekou East Street, Xicheng District, Beijing, 100035, China

Background: Symptomatic medial collateral ligament (MCL) instability is rare, and it is frequently associated with multiligament injuries. Most clinical investigations have failed to clearly define the specific objective outcome measures assessing the stability of the MCL quantitatively before and after the reconstruction procedure. Purpose: To quantitatively evaluate the early clinical outcomes of patients with valgus instability of knee joints who had undergonesuperficial MCL reconstruction using Achilles tendon allografts. Study Design: Case series; Level of evidence, 4. Methods: From August 2005 to December 2010, 19 consecutive patients with MCL injuries were included in this study. The inclusion criteria were (1) a subacute or chronicMCL injury, with a time from initial injury to surgery of longer than 3 weeks, and (2) valgus laxity graded C or D according to the International Knee Documentation Committee (IKDC). All patients underwent superficial MCL reconstruction using Achilles tendon allografts. To evaluate the laxity of the MCL preoperatively and postoperatively, valgus stress radiographs using a Telos device were used. Other assessments included the IKDC subjective functional evaluation and Lysholm score estimation. Results: Sixteen of the 19 patients (12 men and 4 women) were available for final follow-up. The median age of the patients was 37 years (range, 19-53 years); mean body mass index (BMI) was 26.4 (range, 21.7-29.4). The mean time from injury to surgery was 15.9 months (range, 24 days to 84 months), and median follow-up period was 34 months (range, 24-67 months). The mean medial knee laxity (side-to-side difference) was 8.9 ± 3.2 mm (range, 6-15.9 mm) preoperatively and 1.1 ± 0.9 mm (range, -1.1 to 3.2 mm) postoperatively (P < .001). The preoperative mean IKDC subjective knee functional score was 49.8 ± 6.9 (range, 31-57.5), while the postoperative functional score was 84.3 ± 6.0 (range, 71.3-93.1) (P < .001). The mean Lysholm score was 69.3 ± 5.9 (range, 55-78) preoperatively and 88.6 ± 5.0 (range, 75-95) postoperatively (P < .001). There was no significant correlation between patients' BMI and the final clinical outcome scores (P = .311). Conclusion: In a small set of patients withmultiligament-injured knees, valgus laxity can be effectively restored through surgicalmanagement with superficial MCL reconstruction, when the other associated ligament injuries are reconstructed as well. The subjective functional results were significantly improved postoperatively at short-term follow-up.