The Effect Of Medial Collateral Ligament Injury In Operation For Anterior Cruciate Ligament Reconstruction Stability In Axial

Objective: The anterior cruciate ligament (ACL) injury is common inclinical. After anterior cruciate ligament injury can lead to knee instability.The ACL injuries combined with medial collateral ligament injury frequentlywhile the percent of the grade III medial collateral ligament injury followedwas up to95%. Presently, after ACL injury on the need for surgicalreconstruction to restore the stability of the knee has been a commonunderstanding. The grade I°and II°MCL injury is often treatedconservatively with satisfactory results, while the MCL III°injury need tosurgery maximized recovery the function of the knee which prevents the kneevalgus. However, the effect of medial collateral ligament injury in operationfor anterior cruciate ligament reconstruction stability is rare in domestic andinternational coverage.Contrast ACL reconstruction only to combined ACL reconstructionsurgery and MCL repair,the author analysis the difference on maximumforward displacement of knee, graft diameter,ROM, IKDC score and medialjoint widening gap from X ray in valgus stress position, and provide referencefor clinical.Methods: We take43patients who had acute ACL and MCL III°injuryor only ACL injury in the third hospital of Hebei Medical University fromNovember of2010to June of2012.It is25cases of simple ACL injury (Agroup). Preoperative inspection shows anterior drawer test positive, afterdrawer test negative, valgus stress test negative. The MRI examination showedcomplete disappearance or discontinuity of ACL. It is18cases of ACL injuriescombined MCL III°(Group B). Preoperative inspection shows anteriordrawer test positive, after drawer test negative, both0°and30°valgus stresstest negative. The MRI examination showed complete disappearance or discontinuity of ACL, high signal of MCL femoral insertion. All patients had aclear history of trauma, duration<2weeks. All patients were taken theKT-1000knee arthrometer at30°of the knee, record the maximum forwarddisplacement, the range of motion and the international knee documentationcommittee knee uation form(IKDC Score). The single-boundle tchcnique inthe ACL reconstruction is operatied on A group, and the ACL reconstructionand MCL repair is operatied on B group. Postoperatively functional recoveryexercise is guided to all of the patients. And the author analysis thedifference on maximum forward displacement of knee, graft diameter,ROM,IKDC score and medial joint widening gap from X ray in valgus stressposition by SPSS13.0software.Results: Comparison the maximum forward displacement of knee,ROM,IKDC score before and after the surgery respectively,there’s statisticalsignificance on the difference of both group A and B(P <0.05).Compairedwith group A and B on the difference of maximum forward displacement ofknee, graft diameter,ROM and IKDC score before surgry, there’s no statisticalsignificance（P＞0.05）. Compaired with group A and B on the difference ofROM and IKDC score after surgry, there’s no statistical significance（P＞0.05）. KT-1000test: In flexion30°, under20pounds tension,the maximumforward displacement of the knee in group A is （8.5±2.0）mm before surgryand（2.5±0.7）mm after surgry, and the maximum forward displacement of theknee in group B is （9.6±1.9）mm before surgry and （3.5±1.2）mm aftersurgry. There were significant differences between the preoperative andpostoperative on the maximum forward displacement of the knee (P <0.05).There were significant differences between the group A and B on themaximum forward displacement of the knee postoperatively(P<0.05).Compaired medial joint widening gap from X ray in valgus stress positionbetween group A（1.4±0.7mm）and B（3.0±0.8mm）postoperatively, there’sstatistical significance（P <0.05）.Conclusion: Contrast the patients combinedACL reconstruction surgeryand MCL repair，the axial stability and the function of the knee are got better recovery on patients with acute ACL injury alone be given ACL reconstruction.The patients rehabilitation exercises postoperatively combined ACLreconstruction surgery and MCL repair should be more cautious, scienceformaximum recovery of the knee axial stability.