NA - Utvikling av en ny operasjonsmetode for kneligamentskader

Medial collateral ligament (MCL) injuries are the most common knee ligament injury. Such injuries are thought to be over twice as common as ACL tears. But the exact functional role of the main medial structures, the tibial collateral ligament (TCL or als o known as the superficial medial collateral ligament), the posterior oblique ligament, and the deep MCL is not known. This uncertainty has become increasingly important as the universally accepted methods of treating all MCL injuries by nonoperative mea ns5 has been found to produce a large amount of unsatisfactory results. Thus, surgical reconstruction would be the next step in the clinical care cycle, but the underlying question is which structures should be reconstructed. We have successfully dealt w ith a similar clinical dilemma on the lateral side of the knee. To solve this problem we, the orthopaedic surgery departments at the University of Minnesota and University of Oslo, performed a comprehensive cooperative program of study. Initially, we st udied and quantified the exact anatomy of the lateral side of the knee7. The next step was to understand the role of each specific structure10 and its effect on anterior and posterior cruciate ligament reconstructions9 8. Finally, we compiled all this information, developed a reconstruction for the lateral side of the knee, and mechanically validated this method6. We plan to perform a similar comprehensive program of study on the medial side, outlined by the following specific aims, to answer the ques tions which medial structures are functionally important and then develop an anatomic reconstruction method to address the instability.