The Journal of Bone and Joint Surgery, Vol 76, Issue 9 1328-1344, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
The importance of the posterior oblique ligament in repairs of acute tears of the medial ligaments in knees with and without an associated rupture of the anterior cruciate ligament. Results of long-term follow-up
JC Hughston
Hughston Orthopaedic Clinic, Columbus, Georgia.
Forty-one of fifty patients (fifty knees) who had had a repair of an acute
tear of the medial ligaments, a procedure in which repair of the posterior
oblique ligament and the semimembranosus complex was emphasized, were
re-evaluated after an average duration of follow-up of twenty-two years
(range, eighteen to thirty years). The ages of the patients at the time of
the injury had ranged from fifteen to twenty-one years. In twenty-four of
the forty-one knees, the anterior cruciate ligament had been torn. In
seventeen of these knees, the torn ligament had been debrided; in six
others, which had had avulsion of a bone fragment or a terminal tear, the
ligament had been repaired with absorbable sutures; and in the remaining
knee, the repaired anterior cruciate ligament had been augmented. Four
patients had had a pes anserinus transfer to supplement the medial repair.
The medial meniscus had been intact or repaired in twenty-five of the
forty-one knees and had been removed from the remaining sixteen. The
lateral meniscus had been retained in thirty-nine knees and removed from
two. Postoperatively, all knees had been immobilized for six weeks in 60
degrees of flexion by means of a plaster cast. This had not caused lasting
loss of motion, persistent muscle atrophy, or clinically demonstrable
deterioration of the articular cartilage. In the twenty-four knees that had
had a tear of the anterior cruciate ligament, the rates of instability,
meniscal injury, and deterioration of the joint had not increased since the
time of treatment, compared with those in the knees with an intact
ligament, even though repair and augmentation of this ligament had not been
performed (except in one patient, in whom it was unsuccessful).
Thirty-eight patients had good stability and a normal range of motion, as
well as little or no muscle atrophy. Radiographic changes were slight or
absent in all but four knees. Most patients had maintained a high level of
physical fitness and recreational athletic activity. There were three
failures of treatment (7 per cent). This previously described treatment of
acute tears of the medial ligaments, with or without an associated tear of
the anterior cruciate ligament, provides good long-term results and is
still recommended.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
