Surgical Technique: Development of an Anatomic Medial Knee Reconstruction

Robert F. LaPrade MD, PhD, Coen A. Wijdicks PhD
Symposium: Complex Knee Ligament Surgery
Volume 470, Issue 3 / March , 2011

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Abstract

Background

The main static stabilizers of the medial knee are the superficial medial collateral and posterior oblique ligaments. A number of reconstructive techniques have been advocated including one we describe here. However, whether these reconstructions restore function and stability is unclear.

Description of Technique

This anatomic reconstruction technique consisted of reconstruction of the proximal and distal divisions of the superficial medial collateral and the posterior oblique ligament using two separate grafts.

Patients and Methods

We prospectively followed all 28 patients (19 male, nine females) who had this new reconstruction between 2007 and 2009. The average age was 32.4 years (range, 16–56 years). There were eight acute and 20 chronic injuries. All patients presented with side-to-side instability with activities of daily living and other higher level activities. Minimum followup was 6 months (average, 1.5 years; range, 0.5–3 years). No patients were lost to followup.

Results

Preoperative International Knee Documentation Committee subjective outcome scores averaged 43.5 (range, 14–66) and final postoperative values averaged 76.2 (range, 54–88). Preoperative valgus stress radiographs averaged 6.2 mm of medial compartment gapping compared with the contralateral normal knee, whereas postoperative stress radiographs averaged 1.3 mm.

Conclusions

Early observations suggest this anatomic reconstruction technique improves overall patient function and restores valgus instability.

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