Healing of Acute Collateral Ligament Tears Associated with Cruciate Ligament Injuries Treated Conservatively by Early Protective Motion.

概要

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The purpose of this study was to evaluate natural healing of the collateral ligament associated with cruciate ligament injury when treated conservatively by early protective motion. Acute ligamentous injuries of the MCL in 10 patients and of the LCL in another 3 patients, who had concomitant ACL injury in 11 patients and PCL in 2 patients, were the subjects of this study. A Kyuro knee brace with a coil-spring traction system was used to add adequate but not excessive stress to the injured tissues at an early stage. Dynamic joint control training was conducted progressively to improve the muscles ability to protect the joint. All patients were examined before treatment and then re-examined after the 3-month treatment, both radiologically and arthroscopically. Ten patients were also evaluated by MR imaging. Lateral laxity on stress radiographs under anaesthesia decreased from an average of 13.5 to 5.5mm (p<0.01) after treatment. Most of the arthroscopic findings of ruptured ligaments returned to a normal appearance. Results that were rated as "good to excellent" were obtained in 90% of those examined by MRI. Associated ACL healed well, but PCL poorly. We concluded that acute collateral ligament tears can be healed morphologically and mechanically by this non-surgical method, even when complicated with cruciate ligament injuries.
西日本整形・災害外科学会の論文