Treatment of acute anterior cruciate and medial collateral ligament injuries of knee

Objective To study the treatment modalities for acute anterior cruciate ligament（ACL） and medial collateral ligament（MCL） injuries. Methods Fifty-eight patients with acute ACL and MCL injuries（including gradeⅠin 7,gradeⅡin 25 and grade Ⅲ in 26 cases） were treated in our department from December 2002 to October 2008.ACL was reconstructed when the knee function was recovered in 32 patients with gradeⅠand gradeⅡMCL injury after they were immobilized for 3-4 weeks,in 7 patients with gradeⅢMCL injury after they were immobilized for 6 weeks,in 19 patients with gradeⅢMCL injury after they were immobilized for 2 weeks.Valgus stress testing for full extension and 300 of flexion was negative in 11 patients and positive in 8 patients after they were immobilized for 6-8 weeks.Posterior knee capsule tear in 6 patients was repaired with its posteromedial structure immobilized for 6-8 weeks using suture anchor techniques. Results The patients were followed up for 15 months（range 6-34 months）.Thirty-two patients with gradesⅠandⅡtears were negative for Valgus stress testing,and 2 patients were（+） for anterior drawer test with a Lysholm score of 91.2 after operation.Eighteen patients with gradesⅢtear received conservative treatment with degreesⅠandⅡof Valgus stress testing in 3 and 1 patient,respectively.Anterior drawer test was（+） and（++） in 2 and 1 patient,respectively,with a Lysholm score of 86.5 after operation.Eight patients with gradeⅢtears were treated with suture anchor with degreeⅠof Valgus stress testing in 2 patients,（+） of anterior drawer test in 1 patient,and a Lysholm score of 89.3 after operation. Conclusion Early operation should be performed for acute ACL and MCL injuries.MCL injuries should be repaired after ACL reconstruction if its Valgus stress testing is instable.