The Comparative Analysis Of The Clinical Efficacy Of Grade-Ⅲ Medial Collateral Ligament Tear By Conservation And Surgical Treatment In The Case Of Acute Anterior Cruciate Ligament Injuries With Grade Ⅲ Medial Collateral Ligament Tears

Objective:To evaluate and compare the difference of clinical efficacy between surgery treatment and conservative treatment of medial collateral ligament(MCL)in the case of anterior cruciate ligament(ACL)injuries simul(at the same time)gradeⅢ medial collateral ligament injuries.Method:All 38 patients of ALC injuries simul gradeⅢMCL injuries were selected from The First Hospital Affiliated to Dalian Medical University during June 2013 to June 2016 were dived into two group.The 38 patients were subjected to anterior cruciate ligament reconstruction under arthroscopy after immobilization 1-2weeks.After the reconstruction of ACL,17 patients were positive for Valgus stress testing,whose MCL were repaired by limited open suture anchor,immobilized for 1 week;21 patients were negative for Valgus stress testing,who were immobilized for 4-6 weeks.Functional Results of these patients from the two groups were graded by the Lysholm scores and IKDC scores.The experimental result of patients’ Valgus stress testing and anterior drawer test,the medical costs,the postoperative hospital stay and the time needed to resume normal life should be collected and recorded.Results:The operation of 38 patients from the two groups were performed successfully.The patients were followed up for 18month.The incisions of them healed at the first grade.There no complication and accidental injury occurred during this follow-up period in two groups.Among the 21 patients(group MCL conservative treatment)which received conservative treatment,5 patients were(＋)for anterior drawer test(ADT),1 patient was(++)for ADT,5 patients were degree I,2 patients were degree II for Valgus stress testing.Among the 17 patients(group MCL repaired)which received surgery treatment,3 patients were(+)for anterior drawer test(ADT),3 patients were degree I for Valgus stress testing.The difference of group MCL conservative treatment and group MCL repaired postoperative Lysholm scores had statistical significance(P<0.05).The difference of group MCL conservative treatment group and group MCL repaired postoperative IKDC scores had statistical significance(P<0.05).The difference of the two groups’ medical cost and the time needed to resume normal had no statistical significance(P>0.05).There was no statistical significance for the difference of the operation time and the length of postoperative hospital stay(P>0.05).Conclusion:In the case of ACL injuries simul gradeⅢMCL injuries,Compared to conservative treatment,operative treatment for the MCL could do better to knee joint recovery and make patients resume to normal life earlier.But the cost of MCL repair is higher.When the ACL injuries combined gradeⅢMCL injuries,repairing MCL in one-stage operation can significantly improve the stability and function of knee.