Medial Collateral Ligament Reconstruction Using Peroneus Longus Tendon Fixed By Interference Screw And Endobutton Fixation Device

Objective : To evaluate clinical effects of medial collateral ligament(MCL)reconstruction using peroneus longus tendon fixed by interference screw and Endobutton fixation device.Materials and Methods: Between September 2013 and June 2016,29 patients treated with medial collateral ligament reconstruction using peroneus longus tendon fixed by interference screw and Endobutton fixation device.All of the arthroscopic surgeries were finished by the same operator.3 of the patients were lost followed up and the clinical data of the other 26 patients were retrospectively analyzed.There were 14 males and 12 females with a mean age of 40.3 years,ranged from 20 years to 63 years,left side in 15 cases and right side in 11 cases.Injury was caused by sports in 5 cases,by traffic accident in 6 cases,by accidental falls in 11 cases and by torsion injury in 4 cases.The disease duration ranged from 3 days to 4.5 months,mean 0.9 month.All patients were single knee MCL injury,no other ligament injury and 13 cases with meniscus injury.The femoral fixation was via interference screw and the tibial fixation via Endobutton.The distance of medial joint separation from 0 degrees and 30 degrees of flexion Stress x-rays,the difference between the medial and lateral joint separation from 0 degrees and 30 degrees of flexion Stress x-rays,range of motion,the Lysholm subjective score,the International Knee Documentation Committee(IKDC)subjective knee scores were assessed in both preoperatively and postoperatively of the injury knee and postoperatively of the normal knee.The last follow-up use gait analysis with double side.Results: In the surgery side,the distance of medial joint separation from 0 degrees of flexion Stress x-rays was respectively from 12.31mm±1.78 mm before surgery to 4.06mm±1.39 mm,the difference between the medial and lateral joint separation from 0 degrees of flexion Stress x-rays was respectively from 8.06mm±1.24 mm before surgery to-0.44mm±1.31 mm,the distance of medial joint separation from 30 degrees of flexion Stress x-rays was respectively from 12.56mm±1.59 mm before surgery to 4.25mm±0.93 mm,the difference between the medial and lateral joint separation from 30 degrees of flexion Stress x-rays was respectively from 8.68mm±1.40 mm before surgery to-0.06mm±1.18 mm,the extension degrees was respectively from 3.44°±6.25° before surgery to 0.00°±0.00°,the flexion degrees was respectively from 110.94°±18.46° before surgery to 137.50°±5.47°,the Lysholm subjective score was respectively from 44.56±14.44 before surgery to 97.13±3.59,the IKDC subjective score was respectively from 50.43±6.06 before surgery to 81.32±5.03,P<0.05.In the normal side,the distance of medial joint separation from 0 degrees of flexion Stress x-rays was 4.38mm±0.89 mm,the difference between the medial and lateral joint separation from 0 degrees of flexion Stress x-rays was-0.25mm±0.93 mm,the distance of medial joint separation from 30 degrees of flexion Stress x-rays was 4.44mm±0.89 mm,the difference between the medial and lateral joint separation from 30 degrees of flexion Stress x-rays was-0.63mm±0.72 mm,the extension degrees was 0.00°±0.00°,the flexion degrees was 138.13°±5.43°,the Lysholm subjective score was 98.81±2.81,the IKDC subjective score was 82.83±5.61,the comparison between surgery side and normal side,P>0.05.In gait analysis,abduction/adduction was-14.47°±5.24° in surgery side compared-10.30°±5.97° in normal side,internal/external was-1.57°±6.12° in surgery side compared-0.29°±8.23° in normal side,flexion/extension was 16.57°±3.15° in surgery side compared 16.57°±3.66° in normal side,anterior/posterior was-0.13mm±0.93 mm in surgery side compared-0.43mm±0.53 mm in normal side,distal/proximal was-11.80mm±2.37 mm in surgery side compared-11.15mm±2.01 mm in normal side,medial/lateral was 2.81mm±1.18 mm in surgery side compared 2.47mm±0.88 mm in normal side,P>0.05.Conclusions : The short-term clinical results of medial collateral ligament reconstruction using peroneus longus tendon fixed by interference screw and Endobutton fixation device are satisfactory.This method gain tendon easily and can provide perfect medial stability of the knee,less complications,but the long-term effectiveness needs further follow-up.