Surgical Stabilization of the Medial Capsulo-Ligamentous Envelope in Total Knee Arthroplasty

  • Brandon Green, DO
  • Jon Minter, DO
  • Paul Ghattas, DO
  • Jennifer Waterman, DO

Abstract

This study will evaluate an alternative method in which a four prong bone staple was used to repair the medial collateral ligament following over-release or avulsion injuries in (#6) cases during a total knee arthroplasty. The use of a four prong bone staple to repair medial collateral ligament injuries status post total knee replacement will provide satisfactory results with respect to post-operative knee stability and range of motion. Our retrospective review revealed that all six patients improved with regards to range of motion following the total knee arthroplasty. We feel that repair of the medial collateral ligament with a four-prong bone staple is a viable option after an over-release or avulsion injury sustained during a total knee arthroplasty. 

References

Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop. 1989;248:13-14.

Mounasamy V, Ma SY, Schoderbek RJ, Mihalko WM, Saleh KJ, Brown TE. Primary total knee arthroplasty with condylar allograft and MCL reconstruction for a comminuted medial condyle fracture in an arthritic knee--a case report. Knee. 2006; 5:400-403. Epub 2006 Jul 27.

Peters CL, Dienst M, Erickson J. Reconstruction of the medial femoral condyle and medial collateral ligament in total knee arthroplasty using tendoachilles allograft with a calcaneal bone block. J Arthroplasty. 2004;19:935-940.

Adachi N, Ochi M, Deie M, Izuta Y, Kazusa H. New hamstring fixation technique for medial collateral ligament or posterolateral corner reconstruction using the mosaicplasty system. Arthroscopy. 2006;22:571.e1-3.

Marx RG, Hetsroni I. Surgical technique: medial collateral ligament reconstruction using Achilles allograft for combined knee ligament injury. Clin Orthop Relat Res. 2012;470:798-805.

Edson CJ. Conservative and postoperative rehabilitation of isolated and combined injuries of the medial collateral ligament. Sports Med Arthrosc. 2006;14:105-110

Leopauld SS, McStay C, Klafeta K, Jacobs JJ, Berger RA, Rosenberg AG. Primary Repair of Intraoperative Disruption of the Medial Collateral Ligament During Total Knee Arthroplasty. J Bone Joint Surg AM. 2001;83:86-92.

Hartford JM, Goodman SB, Schurman DJ, Knoblick G. Complex primary and revision total knee arthroplasty using a condylar constrained prosthesis: an average 5 year followup. J Arthroplasty. 1998;13:380-387.

Whiteside LA. Correction of ligament and bone defects in total arthroplasty of the severely valgus knee. Clin Orthop. 1993;288:234-235.

Rand JA. Revision total knee arthroplasty using the Total Condylar III Prosthesis. J. Arthroplasty. 1991;6:279-284.

LaPrade RF, Engebresten AH, Ly TV, Johansen S, Wentorf FA, Engebresten L. The anatomy of the medial part of the knee. J Bone Joint Surg AM. 2007;89:2000-2010.

Wijdicks CA, Griffith CJ, Johansen S, Engebretsen, L, LaPrade RF. Injuries to the Medial Collateral Ligament and Associated Medial Structures of the Knee. J Bone Joint Surg AM. 2010;92:1266-1280.

Griffith CJ, Wijdicks CA, LaPrade RF, Armitage BM, Johansen S, Engebretsen L. Force Measurements on the posterior oblique ligament and superficial medial collateral ligament proximal and distal divisions to applied loads. AM J Sports Med. 2009;37:140-148.

Fischer RA, Arms SW, Johnson RJ, Pope MH. The functional relationship of the posterior oblique ligament to the medial collateral ligament of the human knee. Am J Sports Med. 1985;13:390-397.

Winiarsky R, Barth P, Lotke P. Total knee arthroplasty in morbidly obese patients. J Bone Joint Surg Am. 1998 Dec;80(12):1770-1774.

Published
2014-10-01
How to Cite
Green, DO, B., Minter, DO, J., Ghattas, DO, P., & Waterman, DO, J. (2014). Surgical Stabilization of the Medial Capsulo-Ligamentous Envelope in Total Knee Arthroplasty. Reconstructive Review, 4(3). https://doi.org/10.15438/rr.4.3.75
Section
Original Article