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Postoperative return of motion in anterior cruciate ligament and medial collateral ligament injuires

The effect of medial collateral ligament rupture location

Division of Orthopedic Surgery, University of Utah School of Medicine, Salt Lake City, Utah

Alan P. Newman

Division of Orthopedic Surgery, University of Utah School of Medicine, Salt Lake City, Utah

Robert T. Burks

Division of Orthopedic Surgery, University of Utah School of Medicine, Salt Lake City, Utah

Twenty consecutive patients with combined anterior cruciate/medial collateral ligament injuries were ana lyzed to determine if a correlation exists between the location of medial collateral ligament disruption and postoperative return of motion. All patients were treated operatively by autogenous patellar tendon an terior cruciate ligament reconstruction and primary me dial collateral ligament repair. The mean followup was 379 days.

The patients (12 men and 8 women; mean age, 23 years) were divided into two groups based on the location of superficial medial collateral ligament rupture. Group P consisted of 13 patients with lesions at or proximal to the joint line; Group D consisted of 7 patients with disruptions distal to the joint line.

Group D patients had a more rapid return of motion for both flexion and extension. At the conclusion of followup, patients from Group D also achieved 8° more flexion and 3° more extension. There were eight addi tional procedures performed on five patients, all from Group P, required to treat difficulty regaining motion.

Among those patients with anterior cruciate/medial collateral ligament injuries there are two distinct groups, each with different prognoses related to return of mo tion based on the location of the medial collateral liga ment disruption. We suggest that patients with double- ligament injuries, where the medial collateral ligament lesion is proximal, should be managed very aggres sively to regain motion.

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