Arthroscopic Posteromedial Corner Reconstruction: A Novel Technique and Case Series

Document Type : RESEARCH PAPER

Authors

1 Department of Orthopedic Surgery, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

2 Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

3 Department of Sports and Exercise Medicine, School of Medicine, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

4 Department of MPH, Shiraz University of Medical Sciences, Shiraz, Iran

5 Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

6 Department of Biomedical Engineering, Sciences and Research Branch, Islamic Azad University, Tehran, Iran

10.22038/abjs.2023.76118.3534

Abstract

Objectives: This study aimed to introduce a novel arthroscopic treatment for medial and posteromedial 
instability of the knee and present the primary and follow-up results.
Methods: All patients who underwent the arthroscopic approach to treat medial and posteromedial corner instability 
from 2007 to 2017 were included in this report. Overall, 45 patients were included, among which 75.6% were male. 
The mean age of patients was 32.2 ± 8.4 years. Overall, 44.4% and 15.6% of patients had associated meniscal 
injuries and chondral lesions, respectively. The mean follow-up duration of patients was 84.2 ± 25.3 months.
Results: Overall, 37 patients developed a full range of motion (82.2%), and most patients (95.6%) showed excellent 
quadriceps strength (grades 4 and 5). All patients had a normal or 1+ posterior drawer test, Pivot shift test, and 
Lachman test on physical examination. Moreover, 60% had an associated isolated anterior cruciate ligament injury, 
17.8% had an isolated posterior collateral ligament injury, and 17.6% had a combination of more than one ligament 
injury. One patient developed septic arthritis. Two patients experienced pain, and one pain patient developed pain 
with a bony spur formation in the medial epicondyle. Three patients showed a 2+ medial collateral ligament (MCL) 
test (moderate instability) at the final follow-up, all of whom had multi-ligament injuries. All patients, except the three 
patients who had a failed MCL reconstruction, returned to their previous activities.
Conclusion: This study described a novel arthroscopic treatment of MCL injury, and the results showed acceptable 
postoperative and clinical outcomes. As the use of minimally invasive surgery may minimize multiple complications 
associated with open surgery, it is suggested that further studies be conducted regarding this approach when faced 
with patients who have MCL injuries requiring surgery.
 Level of evidence: IV

Keywords

Main Subjects

References

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The Archives of Bone and Joint Surgery
Volume 12, Issue 4
April 2024
Pages 245-255

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History

  • Receive Date: 09 December 2023
  • Revise Date: 18 January 2024
  • Accept Date: 14 December 2023

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