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임홍철,심재학,남혁우,왕준호,노영진 대한스포츠의학회 2000 대한스포츠의학회지 Vol.18 No.2
Purpose : The medial collateral ligament injury is the most common injury of the knee. Recently Non-operative treatment has been preferred than operative treatment and most of patients have satisfactory clinical results after non-operative treatment. But a few patients have continuous instability after non-operative treatment, so the purpose of this study is to fine out the cause of persistent symptom. Methods and Materlals : We performed a retrospective study of one hundred thirty seven patients with medial collateral ligament injury treated non-operative from January 1990 to December 1997. W divided patients into two groups: isolated medial collateral ligament injury (groupⅠ): medial collateral ligament injury with concomitant anterior cruciate ligament injury (groupⅡ) and we analysed MRI finding, valgus instability, and Lysholm knee score. Result : At the follow up, three of group Ⅰ, five of group Ⅱ had persistent grade Ⅲ valgus instability. In group Ⅰ, we could find two case of rupture of the proper of medial collateral ligament with inward inversion and one case of concomitant posteromedial compartment injury. We could find the proper rupture of medial collateral ligament with inversion inward in two patients, the injury of posteromedial compartment in one patient. Two patients of group Ⅱ with grade Ⅲ valgus instability had anterior instability with laxity of grafted tendon after anterior cruciate ligament reconstruction. Conclusion : Most of isolated injury of the medial collateral ligament heals wthout operative intervention. But in case of rupture of the proper portion of medial collateral ligament with inversion inward or concomitant injury of posteromedial compartment, we should consider the operative treatment of medial collateral ligament. In case of medial collateral ligament injury with anterior cruciate ligament, it would better to consider the delicate reconstruction of anterior cruciate ligament.