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Management of Less Frequent and Multi-ligament Knee Injuries

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Abstract

The knee with multi-ligament injuries is a complex problem with a significant potential morbidity in terms of pain, instability and dysfunction. For some injury patterns, there is consensus as to whether to repair or reconstruct the damaged soft tissues, whilst for others, best treatment strategies remain unclear.

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References

  1. Myasaka KC, Daniel D, Stone ML, Hirschmann P. The incidence of knee ligament injuries in the general population. Am J Knee Surg. 1991;4:3–7.

    Google Scholar 

  2. Shelbourne KD, Gray T. Minimum 10-year follow-up of patients after an acute, isolated posterior cruciate ligament injury treated non-operatively. Am J Sports Med. 2013;41(7):1526–33.

    Article  PubMed  Google Scholar 

  3. Ogata K, McCarthy JA, Dunlap J, et al. Pathomechanics of posterior sag of the tibia in posterior cruciate deficient knees. An experimental study. Am J Sports Med. 1988;16(6):630–6.

    Article  CAS  PubMed  Google Scholar 

  4. Servant CTJ, Ramos JP, Thomas NP. The accuracy of magnetic resonance imaging in diagnosing chronic posterior cruciate ligament injury. Knee. 2004;11:265–70.

    Article  PubMed  Google Scholar 

  5. Pacheco R, Ayre C, Bollen SR. Posterolateral corner injury associated with ACL rupture a commonly missed diagnosis. J Bone Jt Surg. 2011;93B:194–7.

    Article  Google Scholar 

  6. Burks RT, Schaffer JJ. A simplified approach to the tibial attachment of the posterior cruciate ligament. Clin Orthop Relat Res. 1990;254:216–9.

    Google Scholar 

  7. Nuelle CW, Milles JL, Pfeiffer FM, et al. Biomechanical comparison of five posterior cruciate ligament reconstruction techniques. J Knee Surg. 2017;30(6):523–31.

    Article  PubMed  Google Scholar 

  8. Jung TM, Lubowicki A, Wienand A, Wagner M, Weiler A. Knee stability after posterior cruciate ligament reconstruction in female versus male patients: a prospective matched-group analysis. Arthroscopy. 2017;27(3):399–403.

    Article  Google Scholar 

  9. Wajsfisz A, Christel P, Djian P. Does reconstruction of isolated chronic posterior cruciate ligament injuries restore normal knee function? Orthop Traumatol Surg Res. 2010;96(4):388–93.

    Article  CAS  PubMed  Google Scholar 

  10. Becker EH, Watson JD, Dreese JC. Investigation of multiligamentous knee injury patterns with associated injuries presenting at a level I trauma center. J Orthop Trauma. 2013;27(4):226–31.

    Article  PubMed  Google Scholar 

  11. Fanelli GC, Edson CJ. Posterior cruciate ligament injuries in trauma patients, part II. Arthroscopy. 1995;11(5):526–9.

    Article  CAS  PubMed  Google Scholar 

  12. Harner CD, Hoher J. Evaluation and treatment of posterior cruciate ligament injuries. Am J Sports Med. 1998;26(3):471–82.

    Article  CAS  PubMed  Google Scholar 

  13. Kim SJ, Jung M, Moon HK, Kim SG, Chun YM. Anterolateral transtibial posterior cruciate ligament reconstruction combined with anatomical reconstruction of posterolateral corner insufficiency: comparison of single-bundle versus double-bundle posterior cruciate ligament reconstruction over a 2- to 6-year follow-up. Am J Sports Med. 2011;39(3):481–9.

    Article  PubMed  Google Scholar 

  14. Kim SJ, Kim SH, Chun YM, Hwang BY, Choi DH, Yoon JY. Clinical comparison of conventional and remnant-preserving transtibial single-bundle posterior cruciate ligament reconstruction combined with posterolateral corner reconstruction. Am J Sports Med. 2012;40(3):640–9.

    Article  PubMed  Google Scholar 

  15. Kennedy NI, Wijdicks CA, Goldsmith MT, et al. Kinematic analysis of the posterior cruciate ligament, part 1: the individual and collective function of the anterolateral and posteromedial bundles. Am J Sports Med. 2013;41(12):2828–38.

    Article  PubMed  Google Scholar 

  16. Xu X, Huang T, Liu Z, et al. Hamstring tendon autograft versus LARS artificial ligament for arthroscopic posterior cruciate ligament reconstruction in a long-term follow-up. Arch Orthop Trauma Surg. 2014 Dec;134(12):1753–9.

    Article  PubMed  Google Scholar 

  17. Yang JH, Yoon JR, Jeong HI, et al. Second-look arthroscopic assessment of arthroscopic single-bundle posterior cruciate ligament reconstruction: comparison of mixed graft versus Achilles tendon allograft. Am J Sports Med. 2012 Sep;40(9):2052–60.

    Article  PubMed  Google Scholar 

  18. Gray H, Fedden WF, Jex-Blake AJ, Howden R. Anatomy, descriptive and applied. New York: Longmans, Green; 1918.

    Google Scholar 

  19. LaPrade RF, Ly TV, Wentorf FA, Engebretsen L. The posterolateral attachments of the knee: a qualitative and quantitative morphologic analysis of the fibular collateral ligament, popliteus tendon, popliteofibular ligament, and lateral gastrocnemius tendon. Am J Sports Med. 2003;31(6):854–60.

    Article  PubMed  Google Scholar 

  20. Ewan WJ, LaPrade C, LaPrade RF. Anatomy and biomechanics of the lateral side of the knee. Sports Med Arthrosc Rev. 2015;23(1):2–9.

    Article  Google Scholar 

  21. Geeslin AG, Laprade RF, Geeslin AG, Laprade RF. Location of bone bruises and other grade III isolated and combined. Am J Sports Med. 2010;38(12):2502–8.

    Article  PubMed  Google Scholar 

  22. Fanelli GC. Treatment of combined anterior cruciate ligament-posterior cruciate ligament-lateral side injuries of the knee. Clin Sports Med. 2000;19(3):493–502.

    Article  CAS  PubMed  Google Scholar 

  23. Hughston JC, Andrews JR, Cross MJ, Moschi A. Classification of knee ligament instabilities. Part II. The lateral compartment. J Bone Jt Surg Am. 1976;58(2):173–9.

    Article  CAS  Google Scholar 

  24. Schenck RC Jr. The dislocated knee. Instr Course Lect. 1994;43:127–36.

    PubMed  Google Scholar 

  25. Schweller EW, Ward PJ. Posterolateral corner knee injuries: review of anatomy and clinical evaluation. JAOA. 2015;115(12):725–31.

    Article  PubMed  Google Scholar 

  26. Ricchetti ET, Sennett BJ, Huffman GR. Acute and chronic management of posterolateral corner injuries of the knee. Orthopedics. 2008;31(5):479–90.

    Article  PubMed  Google Scholar 

  27. van der Wal WA, Heesterbeek PJC, van Tienen TG, Busch VJ, van Ochten JHM, Wymenga AB. Anatomical reconstruction of posterolateral corner and combined injuries of the knee. Knee Surg Sports Traumatol Arthrosc. 2016;24(1):221–8.

    Article  PubMed  Google Scholar 

  28. Mccarthy M, Camarda L, Wijdicks CA, Johansen S, Engebretsen L, Laprade RF. Anatomic posterolateral knee reconstructions require a popliteofibular ligament reconstruction through a tibial tunnel. Am J Sports Med. 2010;38(8):1674–81.

    Article  PubMed  Google Scholar 

  29. Niki Y, Matsumoto H, Otani T, Enomoto H, Toyama Y, Suda Y. A modified Larson’s method of posterolateral corner reconstruction of the knee reproducing the physiological tensioning pattern of the lateral collateral and popliteofibular ligaments. Sports Med Arthrosc Rehabil Ther Technol. 2012;4(1):21.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Laprade RF, Wijdicks C. The management of injuries to the medial side of the knee. J Orthop Sports Phys Ther. 2012;42(3):221–33.

    Article  PubMed  Google Scholar 

  31. Fetto J, Marshall J. Medial collateral ligament injuries of the knee: a rationale for treatment. Clin Orthop Relat Res. 1978;132:206–18.

    Google Scholar 

  32. Jacobson KE, Chi FS. Evaluation and treatment of medial collateral ligament and medial-sided injuries of the knee. Sports Med Arthrosc. 2006;14(2):58–66.

    Article  PubMed  Google Scholar 

  33. Kannus P. Long-term results of conservatively treated medial collateral ligament injuries of the knee joint. Clin Orthop Relat Res. 1988;226:103–12.

    Google Scholar 

  34. Warren LFF, Marshall JLL. The supporting structures and layers on the medial side of the knee: an anatomical analysis. J Bone Jt Surg Am. 1979;61(1):56–62.

    Article  CAS  Google Scholar 

  35. Hughston J, Andrews JR, Cross MJ, Moschi A. Classification of knee ligament instabilities * part I. The medial compartment and cruciate ligaments. J Bone Jt Surg. 1976;58-A(2):159–72.

    Article  Google Scholar 

  36. Robinson JR, Sanchez-Ballester J, Bull AM, Thomas Rde W, Amis AA. The posteromedial corner revisited. J Bone Jt Surg. 2004;86(5):674–81.

    Article  CAS  Google Scholar 

  37. Bonnin M, Amendola A, Bellemans J, MacDonald S, Ménétrey J, editors. The knee joint: surgical techniques and strategies. Paris: Springer; 2012.

    Google Scholar 

  38. Robinson JR, Bull AMJ, Thomas RRD, Amis A. The role of the medial collateral ligament and posteromedial capsule in controlling knee laxity. Am J Sports Med. 2006;34(11):1815–23.

    Article  PubMed  Google Scholar 

  39. Griffith C, LaPrade R, Johansen S, Armitage B, Wijdicks C, Engebretsen L. Medial knee injury: part 1, static function of the individual components of the main medial knee structures. Am J Sports Med. 2009;37(9):1762–70.

    Article  PubMed  Google Scholar 

  40. Coobs BR, Wijdicks CA, Armitage BM, et al. An in vitro analysis of an anatomical medial knee reconstruction. Am J Sports Med. 2010;38(2):339–47.

    Article  PubMed  Google Scholar 

  41. Tibor LM, Marchant MH, Taylor DC, Hardaker WT, Garrett WE, Sekiya JK. Management of medial-sided knee injuries, part 2: posteromedial corner. Am J Sports Med. 2011;39(6):1332–40.

    Article  PubMed  Google Scholar 

  42. Haimes JL, Wroble RR, Grood ES, Noyes FR. Role of the medial structures in the intact and anterior cruciate ligament-deficient knee: limits of motion in the human knee. Am J Sports Med. 1994;22(3):402–9.

    Article  CAS  PubMed  Google Scholar 

  43. Smyth MP, Koh JL. A review of surgical and nonsurgical outcomes of medial knee injuries. Sports Med Arthrosc. 2015;23(2):e15–22.

    Article  PubMed  Google Scholar 

  44. Phisitkul P, James SL, Wolf BR, Amendola A. MCL injuries of the knee: current concepts review. Iowa Orthop J. 2006;26(Mcl):77–90.

    PubMed  PubMed Central  Google Scholar 

  45. Hughston JC, Eilers AF. The role of the posterior oblique ligament in repairs of acute medial (collateral) ligament tears of the knee. J Bone Joint Surg Am. 1973;55(5):923–40.

    Article  CAS  PubMed  Google Scholar 

  46. Wijdicks CA, Ewart DT, Nuckley DJ, Johansen S, Engebretsen L, Laprade RF. Structural properties of the primary medial knee ligaments. Am J Sports Med. 2010;38(8):1638–46.

    Article  PubMed  Google Scholar 

  47. Robinson JR, Bull AMJ, Amis AA. Structural properties of the medial collateral ligament complex of the human knee. J Biomech. 2005;38(5):1067–74.

    Article  PubMed  Google Scholar 

  48. Jones L, Bismil Q, Alyas F, Connell D, Bell J. Persistent symptoms following non operative management in low grade MCL injury of the knee & the role of the deep MCL. Knee. 2017;16(1):64–8.

    Article  Google Scholar 

  49. Narvani A, Mahmud T, Lavelle J, Williams A. Injury to the proximal deep medial collateral ligament: a problematical subgroup of injuries. J Bone Jt Surg Br. 2010;92(7):949–53.

    Article  CAS  Google Scholar 

  50. Abbott LC, Saunders JB, Bost FC, Anderson CE. Injuries to the ligaments of the knee joint. J Bone Jt Surg. 1944;26(3):503–21.

    Google Scholar 

  51. Duffy PS, Miyamoto RG. Management of medial collateral ligament injuries in the knee: an update and review. Phys Ther Sport. 2010;38(2):48–54.

    Google Scholar 

  52. Reider B. Medial collateral ligament injuries in athletes. Sports Med. 1996;21(2):147–56.

    Article  CAS  PubMed  Google Scholar 

  53. Kakarlapudi TK, Bickerstaff DR. Knee instability: isolated and complex. West J Med. 2001;174(4):266–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Cross MJ, Wootton JR, Bokor DJ, Sorrenti SJ. Acute repair of injury to the anterior cruciate ligament. A long-term followup. Am J Sports Med. 1993;21(1):128–31.

    Article  CAS  PubMed  Google Scholar 

  55. Mazzoca AD, Nissen CW, Geary M, Adams DJ. Valgus medial collateral ligament rupture causes concomitant loading and damage of the anterior cruciate ligament. J Knee Surg. 2003;16(3):148–51.

    Google Scholar 

  56. O’Donoghue DH. Surgical treatment of injuries to ligaments of the knee. J Am Med Assoc. 1959;169(13):1423–31.

    Article  PubMed  Google Scholar 

  57. Noyes FR, Barber-Westin SD. A systematic review of the incidence and clinical significance of postoperative meniscus transplant extrusion. Knee Surg Sports Traumatol Arthrosc. 2014;23(1):290–302.

    Article  PubMed  Google Scholar 

  58. Slocum DB, Larson RL. Rotatory instability of the knee. J Bone Jt Surg Am. 1968;50(2):211–25.

    Article  CAS  Google Scholar 

  59. Franklin JL, Rosenberg TD, Paulos LE, France EP. Radiographic assessment of instability of the knee due to rupture of the anterior cruciate ligament. A quadriceps-contraction technique. J Bone Joint Surg Am. 1991;73(3):365–72.

    Article  CAS  PubMed  Google Scholar 

  60. Engebretsen L, Lind M. Anteromedial rotatory laxity. Knee Surg Sports Traumatol Arthrosc. 2015;23(10):2797–804.

    Article  PubMed  Google Scholar 

  61. Phisitkul P, Wolf BR, Amendola A. Role of high tibial and distal femoral osteotomies in the treatment of lateral-posterolateral and medial instabilities of the knee. Sports Med Arthrosc. 2006;14(2):96–104.

    Article  PubMed  Google Scholar 

  62. Kurzweil PR, Kelley ST. Physical examination and imaging of the medial collateral ligament and posteromedial corner of the knee. Sports Med Arthrosc. 2015;14(2):67–73.

    Article  Google Scholar 

  63. Loredo R, Hodler J, Pedowitz R, Yeh LR, Trudell D, Resnick D. Posteromedial corner of the knee: MR imaging with gross anatomic correlation. Skelet Radiol. 1999;28(6):305–11.

    Article  CAS  Google Scholar 

  64. Schein A, Matcuk G, Patel D, et al. Structure and function, injury, pathology, and treatment of the medial collateral ligament of the knee. Emerg Radiol. 2012;19(6):489–98.

    Article  PubMed  Google Scholar 

  65. Miller MD, Osborne JR, Gordon WT, Hinkin DT, Brinker MR. The natural history of bone bruises a prospective study of magnetic resonance imaging-detected trabecular microfractures in patients with isolated medial collateral ligament injuries. Am J Sports Med. 1998;26(1):15–9.

    Article  CAS  PubMed  Google Scholar 

  66. Nakamura N, Horibe S, Toritsuka Y, Mitsuoka T, Yoshikawa H, Shino K. Acute grade III medial collateral ligament injury of the knee associated with anterior cruciate ligament tear. The usefulness of magnetic resonance imaging in determining a treatment regimen. Am J Sports Med. 2003;31(2):261–7.

    Article  PubMed  Google Scholar 

  67. Grant JA, Tannenbaum E, Miller BS, Bedi A. Treatment of combined complete tears of the anterior cruciate and medial collateral ligaments. Arthroscopy. 2012;28(1):110–22.

    Article  PubMed  Google Scholar 

  68. Laprade RF, Bernhardson AS, Griffith CJ, Macalena JA, Wijdicks CA. Correlation of valgus stress radiographs with medial knee ligament injuries: an in vitro biomechanical study. Am J Sports Med. 2010;38(2):330–8.

    Article  PubMed  Google Scholar 

  69. Staubli HU, Jakob RP. Posterior instability of the knee near extension. A clinical and stress radiographic analysis of acute injuries of the posterior cruciate ligament. J Bone Jt Surg Br. 1990;72(2):225–30.

    Article  CAS  Google Scholar 

  70. Lerat JL, Moyen BL, Cladière F, Besse JL, Abidi H. Knee instability after injury to the anterior cruciate ligament. Quantification of the Lachman test. J Bone Jt Surg Br. 2000;82:42–7.

    Article  CAS  Google Scholar 

  71. Ellsasser JC, Reynolds FC, Omohundro JR. The non-operative treatment of collateral ligament injuries of the knee in professional football players. An analysis of seventy-four injuries treated non-operatively and twenty-four injuries treated surgically. J Bone Jt Surg Am. 1974;56(6):1185–90.

    Article  CAS  Google Scholar 

  72. Indelicato PA. Non-operative treatment of complete tears of the medial collateral ligament of the knee. J Bone Jt Surg Am. 1983;65(3):323–9.

    Article  CAS  Google Scholar 

  73. Lundberg M, Messner K. Ten-year prognosis of isolated and combined medial collateral ligament ruptures. A matched comparison in 40 patients using clinical and radiographic evaluations. Am J Sports Med. 1997;25(1):2–6.

    Article  CAS  PubMed  Google Scholar 

  74. Derscheid GL, Garrick JG. Medial collateral ligament injuries in football. Nonoperative management of grade I and grade II sprains. Am J Sports Med. 1981;9(6):365–8.

    Article  CAS  PubMed  Google Scholar 

  75. Holden DL, Eggert AW, Butler JE. The nonoperative treatment of grade I and 11 medial collateral ligament injuries to the knee. Am J Sports Med. 1983;11(5):340–4.

    Article  CAS  PubMed  Google Scholar 

  76. Lundberg M, Messner K. Long-term prognosis of isolated partial medial collateral ligament ruptures. A ten-year clinical and radiographic evaluation of a prospectively observed group of patients. Am J Sports Med. 1984;24(2):160–3.

    Article  Google Scholar 

  77. Hildebrand KA, Woo SL, Smith DW, et al. The effects of platelet-derived growth factor-BB on healing of the rabbit medial collateral ligament an in vivo study. Am J Sports Med. 1998;26(4):549–54.

    Article  CAS  PubMed  Google Scholar 

  78. Batten ML, Hansen JC, Dahners LE. Influence of dosage and timing of application of platelet-derived growth factor on early healing of the rat medial collateral ligament. J Orthop Res. 1996;14(5):736–41.

    Article  CAS  PubMed  Google Scholar 

  79. Moorman CT, Kukreti U, Fenton DC, Belkoff SM. The early effect of ibuprofen on the mechanical properties of healing medial collateral ligament. Am J Sports Med. 1999;27(6):738–41.

    Article  PubMed  Google Scholar 

  80. Wright R, Mackey RB, Silva M, Steger-May K. Smoking and mouse MCL healing. J Knee Surg. 2010;23(4):193–9.

    Article  PubMed  Google Scholar 

  81. Stannard JP. Evaluation and treatment of medial instability of the knee. Sports Med Arthrosc. 2015;23(2):91–5.

    Article  PubMed  Google Scholar 

  82. Shelbourne DK. Management of combined and medial injuries collateral ligaments. J Bone Jt Surg Am. 1995;77(5):800–6.

    Article  Google Scholar 

  83. Petersen W, Laprell H. Combined injuries of the medial collateral ligament and the anterior cruciate ligament. Early ACL reconstruction versus late ACL reconstruction. Arch Orthop Trauma Surg. 1999;119(1):258–62.

    Article  CAS  PubMed  Google Scholar 

  84. Noyes FR, Barber-Westin SD. The treatment of acute combined ruptures of the anterior cruciate and medial ligaments of the knee. Am J Sports Med. 1995;23(4):380–91.

    Article  CAS  PubMed  Google Scholar 

  85. Halinen J, Lindahl J, Hirvensalo E, Santavirta S. Operative and nonoperative treatments of medial collateral ligament rupture with early anterior cruciate ligament reconstruction: a prospective randomized study. Am J Sports Med. 2006;34(7):1134–40.

    Article  PubMed  Google Scholar 

  86. Hara K, Niga S, Ikeda H, Cho S, Muneta T. Isolated anterior cruciate ligament reconstruction in patients with chronic anterior cruciate ligament insufficiency combined with grade II valgus laxity. Am J Sports Med. 2008;36:333–9.

    Article  PubMed  Google Scholar 

  87. Kaeding CC, Pedroza AD, Parker RD, Spindler KP, McCarty EC, Andrish JT. Intra-articular findings in the reconstructed multiligament-injured knee. Arthroscopy. 2005;21(4):424–30.

    Article  PubMed  Google Scholar 

  88. Forsythe B, Mascarenhas R, Pombo MW, Harner CD. Combined injuries to the posterior cruciate ligament and medial collateral ligament of the knee. In:The knee joint: surgical techniques and strategies. Paris: Springer; 2012. p. 421–6.

    Chapter  Google Scholar 

  89. Bergfeld JA, McAllister DR, Parker RD, Valdevit AD, Kambic H. The effects of tibial rotation on posterior translation in knees in which the posterior cruciate ligament has been cut. J Bone Joint Surg Am. 2001;83-A(9):1339–43.

    Article  CAS  Google Scholar 

  90. Petersen W, Loerch S, Schanz S, Raschke M, Zantop T. The role of the posterior oblique ligament in controlling posterior tibial translation in the posterior cruciate ligament-deficient knee. Am J Sports Med. 2008;36:495–501.

    Article  PubMed  Google Scholar 

  91. Desai R, Parikh S, Laor T. Intra-articular entrapment of the medial collateral ligament. Orthopedics. 2010;33(9):687.

    PubMed  Google Scholar 

  92. Patel JJ. Intra-articular entrapment of the medial collateral ligament: radiographic and MRI findings. Skelet Radiol. 1999;28(11):658–60.

    Article  CAS  Google Scholar 

  93. Stannard JP, Black BS, Azbell C, D a V. Posteromedial corner injury in knee dislocations. J Knee Surg. 2012;25(5):429–34.

    Article  PubMed  Google Scholar 

  94. Howells NR, Brunton LR, Robinson JR, Porteous AJ, Eldridge JD, Murray JR. Acute knee dislocation: an evidence based approach to the management of the multiligament injured knee. Injury. 2011;42(11):1198–204.

    Article  PubMed  Google Scholar 

  95. Lubowitz JH, Mackay G, Gilmer B. Knee medial collateral ligament and posteromedial corner anatomic repair with internal bracing. Arthrosc Tech. 2014;3(4):e505–8.

    Article  PubMed  PubMed Central  Google Scholar 

  96. Bosworth D. Transplantation of the semitendinosus for repair of laceration of medial collateral ligament of the knee. J Bone Jt Surg Am. 1952;34:196–202.

    Article  Google Scholar 

  97. Kim S-J, Lee D-H, Kim T-E, Choi N-H. Concomitant reconstruction of the medial collateral and posterior oblique ligaments for medial instability of the knee. J Bone Joint Surg (Br). 2008;90(10):1323–7.

    Article  Google Scholar 

  98. Lind M, Jakobsen BW, Lund B, Hansen MS, Abdallah O, Christiansen SE. Anatomical reconstruction of the medial collateral ligament and posteromedial corner of the knee in patients with chronic medial collateral ligament instability. Am J Sports Med. 2009;37(6):1116–22.

    Article  PubMed  Google Scholar 

  99. Yoshiya S, Kuroda R, Mizuno K, Yamamoto T, Kurosaka M. Medial collateral ligament reconstruction using autogenous hamstring tendons: technique and results in initial cases. Am J Sports Med. 2005;33(9):1380–5.

    Article  PubMed  Google Scholar 

  100. Zhang H, Bai X, Sun Y, Han X. Tibial inlay reconstruction of the medial collateral ligament using Achilles tendon allograft for the treatment of medial instability of the knee. Knee Surg Sports Traumatol Arthrosc. 2014;22(2):279–84.

    Article  PubMed  Google Scholar 

  101. Marx RG, Hetsroni I. Surgical technique: medial collateral ligament reconstruction using Achilles allograft for combined knee ligament injury. Clin Orthop Relat Res. 2012;470(3):798–805.

    Article  PubMed  Google Scholar 

  102. Borden PS, Kantaras AT, Caborn DNM. Medial collateral ligament reconstruction with allograft using a double-bundle technique. Arthroscopy. 2002;18(4):E19.

    Article  PubMed  Google Scholar 

  103. Laprade RF, Wijdicks CA. Development of an anatomic medial knee reconstruction. Clin Orthop. 2012;470:806–14.

    Article  PubMed  Google Scholar 

  104. Feeley BT, Muller MS, Allen AA, Granchi CC, Pearle AD. Biomechanical comparison of medial collateral ligament reconstructions using computer-assisted navigation. Am J Sports Med. 2009;37(6):1123–30.

    Article  PubMed  Google Scholar 

  105. Kremen TJ, McAllister DR. Graft selection in multiple ligament injured knee surgery. In: Fanelli GC, editor. The multiple ligament injured knee: a practical guide to management, vol. 115. New York: Springer Science + Business Media; 2013. Chapter 9. p. 115–28.

    Chapter  Google Scholar 

  106. Flahiff CM, Brooks AT, Hollis JM, Vander Schilden JL, Nicholas RW. Biomechanical analysis of patellar tendon allografts as a function of donor age. Am J Sports Med. 1995;23(3):354–8.

    Article  CAS  PubMed  Google Scholar 

  107. West RV, Harner CD. Graft selection in anterior cruciate ligament reconstruction. J Am Acad Orthop Surg. 2005;13:197–207.

    Article  PubMed  Google Scholar 

  108. Weiss NG, Kaplan LD, Graf BJ. Graft selection in surgical reconstruction of the multiple-ligament-injured. Oper Tech Sports Med. 2003;11(3):218–25.

    Article  Google Scholar 

  109. Levy BA, Dajani KA, Whelan DB, et al. Decision making in the multiligament-injured knee: an evidence based systematic review. Arthroscopy. 2009;25(4):430–8.

    Article  PubMed  Google Scholar 

  110. Rodeo SA, Weber AE, Verdonk R, Monllau JC, Heinrichs E-L. The use of allografts in sports medicine. In: Warwick RM, editor. Tissue and cell clinical use. An essential guide. Hoboken: Blackwell Publishing Ltd; 2012.

    Google Scholar 

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Bollen, S., Oussedik, S., Hage, W., Robinson, J., Leyes, M., Monllau, J.C. (2018). Management of Less Frequent and Multi-ligament Knee Injuries. In: Kerkhoffs, G.M.M.J., Haddad, F., Hirschmann, M.T., Karlsson, J., Seil, R. (eds) ESSKA Instructional Course Lecture Book. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-56127-0_19

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