NOTES - Surgical Procedures :

MCL recon/medial capsule plication - - Posted by Beauzer (Beauzer), 9 March 2004

Oh great KNEEguru (or anyone else out there), can you help me?

I have had a nagging question that I can't seem to find the answer to despite perusing this site, the web at large and numerous medical books.    All the info I can find describes medial plication for patellar alignment issues.

In 2000 I had a MCL and medial joint capsule reconstruction by what was called a medial plication.  At the time I slipped and tore my MCL with such force that it ripped open the medial joint capsule too (and shredded what was left of my medial meniscus).  Thankfully, ACL grafts are stronger than native ACL's because my OS said he'd never seen an injury that bad without also rupturing the ACL or completely dislocating the knee.  The injury didn't heal after conservative treatment and the joint was so lax that it was threatening my ACL graft, so...

They did a medial capsular plication.  However, mine involved 2 interference screws and had nothing to do with kneecap realignment.  I can't find anything like this described anywhere.  So, what the heck did they do?  Has anybody else had a medial reconstruction for an injury?  

Somehow I seem to get all the weird stuff
Danielle
Posted by Beauzer (Beauzer), 11 March 2004

Uh, I guess that would be a "no" then?
Posted by admin (The KNEEguru), 12 March 2004

Don't give up on us!  
I'll see if I can find you some helpful literature:


1. http://www.carletonsportsmed.com/Newsletters/Sept%202003%20Newsletter.pdf
2. http://www.aaos.org/wordhtml/anmt2004/poster/p319.htm

How about getting a copy of your op notes?
Posted by Beauzer (Beauzer), 12 March 2004

Hmm...

Thanks KNEEguru.  Those sites gave me some insights.  

Actually I have seen my op report of that procedure.  We think they tightened the MCL, cut the medial joint capsule and pulled it tight and reattached it to the tibia and femur with interference screws.  

My current OS though said he'd never seen anything quite like this repair (or this particular injury at all) in the 25 years he's been doing trauma and sports medicine, though, so that's why we're a little confused still.  Maybe it was a "make-it-up-as-you-go" kind of thing as this type of injury doesn't seem very common.

Thanks again
Danielle
Posted by admin (The KNEEguru), 13 March 2004

It's amazing how often the 'bad knee' re-injures. Proprioception (position sense and force sense) seems to take ages to recover after any knee op, but even more so with cruciates.
Posted by soccerdoc (soccerdoc), 14 March 2004

The comment on proprioception is very astute.  In my experience, working with rehab/pain it is often neglected by therapists or at lest there is a wide range of variability in the attention given to regaining proprioception in the operated lower extremity.

Jim
Posted by brie07 (brie07), 5 May 2004

My mcl avulsed from the tibia and I had to have it reattached with screws. My leg still feels loose. I'm sorry to hear about your injury.

This old Forum was so valuable that we have kept it as an archive. It is just for reference. If you want to ask questions or offer advice, there is also a current Bulletin Board which you can access from our home page.

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