title: [Minimally invasive augmentation of the medial collateral ligament with autologous hamstring tendons in chronic knee instability].
abstract: OBJECTIVE
  Medial collateral ligament reconstruction in chronic unstable knees.
  
  
  METHODS
  Chronic instability of the medial collateral ligament (MCL) isolated or in combination with multiligament injuries.
  
  
  METHODS
  Refixable bony avulsions, limited range of motion, arthrofibrosis, severe valgus deformity, infections, critical soft tissue, lack of patient compliance and open growth plates.
  
  
  METHODS
  Harvesting of the contralateral semitendinosus tendon and preparation. Supine position with leg in electric leg holder. Oblique skin incision above the pes anserinus parallel to the tendons. Placement of drill hole distal to the tibial insertion of the hamstrings in the footprint of the MCL. Tapering and fixation of the transplant. Subfascial tunneling and femoral fixation of the transplant distally to the medial patellofemoral ligament (MPFL) origin in 30° flexion under fluoroscopic control. Tibial fixation of the dorsal portion of the transplant (POL) ventral to the semimembranosus tendon footprint in full extension.
  
  
  METHODS
  Limited weight bearing with 20 kg for 4-6 weeks, stabilizing brace with limited range of motion 0/0/90°.
  
  
  RESULTS
  A total of 9 patients with a median age of 39 (18-70) years received an augmentation of the MCL complex due to a chronic instability using the described technique. Follow-up examination was performed after 16 (11-56) months. All patients reported a stable knee. The median value of the Lysholm score at follow-up was 90 (72-96) points and the Tegner score prior to trauma was 4 (2-6) points and 3 (2-6) points during follow-up. No grade 2 or 3 instability could be observed during follow-up. There were no complications using the above mentioned technique.
authors.affiliation: Sektion Knie- und Schulterchirurgie, Sporttraumatologie, Chirurgisch-Traumatologisches Zentrum, Asklepios Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Preiss
authors.forename: A
authors.initials: A
authors.lastname: Giannakos
authors.forename: K-H
authors.initials: KH
authors.lastname: Frosch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D008297:Male; D017888:Medial Collateral Ligament, Knee / Q000293:injuries* / Q000601:surgery*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D016059:Range of Motion, Articular / Q000502:physiology; D013525:Surgical Instruments; D013710:Tendons / Q000637:transplantation*; D055815:Young Adult