title: Anatomical reconstruction of the medial collateral ligament and posteromedial corner of the knee in patients with chronic medial collateral ligament instability.
abstract: BACKGROUND
  In cases of multiple ligament injury or severe medial collateral ligament (MCL) lesion, nonoperative treatment of the MCL lesion may lead to chronic valgus instability or rotatory instability.
  
  
  OBJECTIVE
  In a retrospective case series after isolated and combined MCL reconstructions using a novel MCL reconstruction technique that addresses both the MCL and the posteromedial corner, an acceptable clinical outcome is expected 2 years after MCL reconstruction.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  From July 2002 to December 2005, 61 patients with grade 3 or 4 medial instability were treated with MCL reconstruction. Median age was 33 years (range, 14-62). Thirteen underwent isolated MCL reconstructions, 34 had combined MCL and anterior cruciate ligament (ACL) reconstruction, and 14 had multiple ligament reconstructions. All patients had reconstruction of the medial collateral and the posteromedial complex using ipsilateral semitendinosus autografts. Fifty patients were available for follow-up more than 24 months postoperatively and were examined by an independent observer using objective International Knee Documentation Committee (IKDC) measures and subjective Knee Injury and Osteoarthritis Outcome Score (KOOS).
  
  
  RESULTS
  At follow-up, medial stability according to the IKDC score showed 98% normal or nearly normal (grade A or B), and for overall IKDC score, patients improved from 5% with grade A or B preoperatively to 74% with grade A or B at follow-up. There were 91% who were satisfied or very satisfied with the result; 88% would go through surgery again. The KOOS improved primarily for sports and quality of life subscales with approximately 10-point improvements.
  
  
  CONCLUSIONS
  Acceptable clinical results with the MCL reconstruction technique were achieved in patients suffering from chronic valgus instability.
authors.affiliation: Division of Sports Trauma, Aarhus Sygehus, Tage Hansens Gade 2, Aarhus DK 8000, Denmark. martinlind@dadlnet.dk
authors.forename: Martin
authors.initials: M
authors.lastname: Lind
authors.forename: Bent Wulff
authors.initials: BW
authors.lastname: Jakobsen
authors.forename: Bent
authors.initials: B
authors.lastname: Lund
authors.forename: Mogens Strange
authors.initials: MS
authors.lastname: Hansen
authors.forename: Ossama
authors.initials: O
authors.lastname: Abdallah
authors.forename: Svend Erik
authors.initials: SE
authors.lastname: Christiansen