Abstract：Objective To investigate the proper treatment of intraoperative injury of medial collateral ligament (MCL) during total knee arthroplasty (TKA).Methods A total of 10 patients (10 knees) with intraoperative MCL injury among 687 patients (714 knees) who received total knee arthroplasty at the department of orthopaedic surgery in Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University from June 2013 to June 2014 were retrospectively analyzed. One of these cases was avulsion of the femoal origin of MCL in which suture anchor was used for its reattachment. The rest were midsubstance disruption which was treated with direct suture repair. Medial stability could not be reconstructed despite meticulous repair of the MCL in 2 of these cases, and constrained liner was used in these 2 cases. Non-constrained posterior stabilized prosthesis was implanted for the other 8 cases. A hinged knee brace was applied to 5 of these cases as part of the postoperative rehabilitation program. American knee society score and range of motion of the knee joint before and after the surgery were recorded and analyzed.Results The mean duration of follow-up was 9 months (range, 3-15 months). No patient had complaint of instability of the knee joint at latest follow-up visit. The mean American knee society score was improved from 76.8 (range, 37-100) pre-operatively to 153.3 (126-170) postoperatively. The mean range of motion of the knee joint was improved from 92°(range, 70°-110°)pre-operatively to 108°(range 90°-120°) postoperatively.Coclusions Intraoperative injury of MCL during TKA should be properly repaired. Good clinical results can be achieved with the use of non-constrained knee prosthesis in these situations if the injured MCL has been repaired and the mechanical axis of the lower extremity has been realigned.
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2014, Vol. 19 
