슬관절 내측부 인대 손상의 보존적 치료

초록

Purpose: Medial collateral ligament (MCL) injury is the most common injury of the knee. Recently, non-operative treatment has been preferred over operative treatment, and most patients achieve satisfactory clinical results after non-operative management. However, a few patients continue to experience instability, and the purpose of this study was to determine the cause of persistent symptoms. Methods and Materials: We performed a retrospective study of 137 patients with MCL injury who were treated non-operatively from January 1990 to December 1997. The patients were divided into two groups: Group I, isolated MCL injury, and Group II, MCL injury with concomitant anterior cruciate ligament (ACL) injury. We analyzed MRI findings, valgus instability, and Lysholm knee scores. Result: At follow-up, three patients in Group I and five patients in Group II had persistent grade III valgus instability. In Group I, we identified two cases of rupture of the proper portion of the MCL with inward inversion and one case with concomitant posteromedial compartment injury. In Group II, two patients with grade III valgus instability showed anterior instability due to laxity of the grafted tendon after ACL reconstruction. Conclusion: Most isolated MCL injuries heal without operative intervention. However, in cases involving rupture of the proper portion of the MCL with inward inversion or concomitant injury of the posteromedial compartment, operative treatment of the MCL should be considered. For patients with combined MCL and ACL injuries, meticulous ACL reconstruction may improve clinical outcomes.

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