PERCUTANEOUS RELEASE OF THE MEDIAL COLLATERAL LIGAMENT DURING KNEE ARTHROSCOPY
DOI:
https://doi.org/10.15674/0030-59872024328-33Keywords:
Arthroscopy, knee joint, medial meniscus, medial collateral ligament, knee instabilityAbstract
The complete visualisation of the internal joint space is crucial for effective knee arthroscopy. However, limited access to certain areas can lead to complications, including cartilage damage. Percutaneous partial release of the medial collateral ligament has been shown to effectively widen the medial compartment of the joint. Objective. This study aimed to determine the effect of percutaneous release of the medial collateral ligament on the postoperative period and restoration of knee joint function. Methods. The patients were divided into two groups: the study group (n = 32) and the comparison group (n = 36). T he study group underwent partial resection of the medial meniscus in combination with percutaneous partial release of the medial collateral ligament, while the comparison group underwent only partial removal of the medial meniscus without widening the medial joint gap. The assessment included pain, functional recovery according to the Tegner Lisholm scale, and the possibility of developing medial instability. Results. The analysis of VAS scores showed a significant reduction in pain in both groups over time. However, there was no significant difference in pain intensity between the two groups during the study. According to the Tegner Lysholm scale, there was a statistically significant improvement in the functional status of patients 6 months after surgery compared to preoperative values in both the study group (p = 0.0034) and the control group (p = 0.0071). However, there was no statistically significant difference between the groups on t he s ame s cale ( p = 0 .871). The study g roup s howed a s light increase in valgus deviation of the tibia (no more than 5o) in 14 (43.75%) patients during the valgus stress test performed on days 7–10 postoperatively. However, after 6 weeks, none of the patients reported any subjective instability or weakness of the knee joint. Therefore, it can be concluded that the procedure was successful. Conclusion. Percutaneous release of the medial collateral ligament to widen the medial aspect during knee arthroscopy has no effect on the postoperative period or the results of partial removal of the medial
meniscus.
References
- Orlyanskyi V., Holovakha M.L. (2007). Manual of knee arthroscopy. Rapids, Dnipropetrovsk, 152. (in russian)
- Xu, C., & Zhao, J. (2013). A meta-analysis comparing meniscal repair with meniscectomy in the treatment of meniscal tears: the more meniscus, the better outcome? Knee Surgery, Sports Traumatology, Arthroscopy, 23(1), 164–170. https://doi.org/10.1007/s00167-013-2528-6
- Perelli, S., Terrón, V. M., & Monllau, J. C. (2023). Meniscal injuries of the knee. Textbook of Musculoskeletal Disorders, 451–459. https://doi.org/10.1007/978-3-031-20987-1_51
- Fakioglu, O., Ozsoy, M. H., Ozdemir, H. M., Yigit, H., Cavusoglu, A. T., & Lobenhoffer, P. (2012). Percutaneous medial collateral ligament release in arthroscopic medial meniscectomy in tight knees. Knee Surgery, Sports Traumatology, Arthroscopy, 21(7), 1540–1545. https://doi.org/10.1007/s00167-012-2128-x
- Roussignol, X., Gauthe, R., Rahali, S., Mandereau, C., Courage, O., & Duparc, F. (2015). Opening the medial tibiofemoral
- compartment by pie-crusting the superficial medial collateral ligament at its tibial insertion: A cadaver study. Orthopaedics & Traumatology: Surgery & Research, 101(5), 529–533. https://doi.org/10.1016/j.otsr.2015.04.002
- Gaudiani, M. A., Knapik, D. M., Kaufman, M. W., Salata, M. J., Voos, J. E., & Karns, M. R. (2020). Percutaneous Superficial Medial Collateral Ligament Release Outcomes During Medial Meniscal Arthroscopy: A Systematic Review. Arthroscopy, Sports Medicine, and Rehabilitation, 2(2), e153-e159. https://doi.org/10.1016/j.asmr.2019.10.009
- Agneskirchner, J. D., & Lobenhoffer, P. (2004). Arthroskopische Meniskuschirurgie: Technisch-operative Verfahren. Der Unfallchirurg, 107(9), 795–802. https://doi.org/10.1007/s00113-004-0841-8
- Hauer, T. M., Wengle, L. J., & Whelan, D. B. (2022). Adjuvant Medial Collateral Ligament Release at the Time of Knee Arthroscopy: A Controlled Percutaneous Technique. Arthroscopy techniques, 11(9), e1541–e1546. https://doi.org/10.1016/j.eats.2022.04.004
- Atoun, E., Debbi, R., Lubovsky, O., Weiler, A., Debbi, E., & Rath, E. (2013). Arthroscopic trans-portal deep medial collateral ligament pie-crusting release. Arthroscopy techniques, 2(1), e41–e43. https://doi.org/10.1016/j.eats.2012.10.008
- Chung, K. S., Ha, J. K., Ra, H. J., & Kim, J. G. (2017). Does Release of the Superficial Medial Collateral Ligament Result in Clinically Harmful Effects After the Fixation of Medial Meniscus Posterior Root Tears?. Arthroscopy: the journal of
- arthroscopic & related surgery: official publication of the Arthroscopy Association of North America and the International
- Arthroscopy Association, 33(1), 199–208. https://doi.org/10.1016/j.arthro.2016.06.030
- Arıcan, G., Ercan, N., Elçi, M., Şahin, О., & Alemdaroglu, B. (2021). Which Fibers of the Medial Collateral Ligament (MCL) Should Be Released in the Pie Crust Technique Applied During Knee Arthroscopy: Superficial MCL or Deep MCL? Cureus, 13(12), e20597. https://doi.org/10.7759/cureus.20597
- Moran, T. E., Demers, A. J., Shank, K. M., Awowale, J. T., & Miller, M. D. (2020). Percutaneous Medial Collateral Ligament Release Improves Medial Compartment Access During Knee Arthroscopy. Arthroscopy, sports medicine, and rehabilitation, 3(1), e105–e114. https://doi.org/10.1016/j.asmr.2020.08.014
- Moran, T. E., Awowale, J. T., Werner, B. C., Fox, M. A., & Miller, M. D. (2020). Associated Morbidity After the Percutaneous Release of the Medial Collateral Ligament for Knee Arthroscopy. Arthroscopy: the journal of arthroscopic & related surgery: official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 36(3), 891–900. https://doi.org/10.1016/j.arthro.2019.08.051
- Herber, A. P., Brinkman, J. C., Tummala, S. V., & Economopoulos, K. J. (2024). Medial Collateral Ligament Pie-Crusting for Isolated Medial Meniscal Root Repair Is Associated With Improved Clinical Outcomes with Minimum 2-Year Follow-Up. Arthroscopy: the journal of arthroscopic & related surgery: official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 40(3), 869–875. https://doi.org/10.1016/j.arthro.2023.07.029
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