Evaluation of the clinical examination in thediagnosis of acute medial collateral ligament injury of the knee joint in comparism with examination under general anesthesia

Abstract

Background: Tear of MCL of the knee is a frequent problem among knee ligaments injuries.Injuries to the MCL are usually caused by contact on the outside of the knee and are accompanied by sharp pain on the inside of the knee. Contrary to most other knee ligaments the medial collateral ligament (MCL) has an excellent ability to heal, being fairly large and well vascularised structure. The vast majority of isolated medial ligament injuries heal without significant long-term problems

Objectives: is to compare between the early clinical examination, and assessment under general anesthesia (GA), and to find out the best methods to assess the MCL tear especially in suspected cases.

Type of the study:Cross- sectional study.

Methods: Fifty patients are collected from casualty & outpatient units from November/2014 to October/2016 with MCL injury  in AL-Kindy teaching hospital.We decided to evaluate them under general anesthesia by valgus stress test at 30 degrees & 0 degrees to estimate the integrity of MCL, in addition to    anterior &posterior Drawer test to evaluate anterior &posterior cruciate ligaments

Results: :  From the 50 patients we select, there were 21 patients seen in the examination to have MCL tear.1 of them were    Grade I ( 4.8% ),14 of them were Grade II (66.7% ),&6 of them were Grade III (28.5%)Associated injuries  with ACL injury  were 5 patients, with  PCL injury    were 1 patient and with medial capsular injury were 2 patients.  Follow up of case range from (2-10) weeks with an average of 6 weeks combined with physiotherapy programs.

Conclusions: Diagnosis of MCL tear by valgus stress test under GA  is the best method for the assessment of MCL tear in suspected cases.