A Clinical Study on Ligamentous Injuries of the Knee

Sohn, Sung Keun; Park, Seung Rim; Yang, Han Sol

Abstract

The function of the knee joint is determined by the anatomical integrity of ligamentous structures, however the ligaments and soft tissues which support by the knee joint are too weak to tolerate forceful stresses. The knee joint is one of the most susceptible joints to ligamentous injury. Recently, the incidence of ligamentous injuries of the knee increased because of rise in traffic accidents and participation in sports. For good results, it is very important to make an early diagnosis and to give prompt management. The authors reviewed 67 cases of ligamentous injuries in patients who were admitted and managed at the Department of Orthopaedic Surgery of Presbyterian Medical Center from March of 1976 to December of 1982. The results of the clinical study are as follows: 1. The prevalent age group is the 3rd through 5th decades, and more frequent in males (8. 6 times). 2. The traffic accident is the most common cause of injury (80. 6%) and many ligamentous injuries were associated with fracture (53. 2%). 3. The most common ruptured individual ligament was the medial collateral ligament. The isolated ligamentous rupture of anterior and posterior cruciate ligament was 3 cases each, but most of the cruciate ligaments were combined with other ligament injury. 4. The rupture sites of the individual ligaments were found to be the following: (a) The medial collateral ligament was ruptured most frequently in the mid-substance (45. 2%), with the deep layer ruptured at the femoral attachment and the superficial layer in the mid-substance; (b) The lateral collateral ligament torn at the fibular attachment (62. 5%); (c) The anterior cruciate ligament torn at the femoral and tibial (47. 6%, respectively); (d) The posterior cruciate ligament torn at the femoral attachment (40. 0%). 5. It is significant if the difference between the normal knee and the injured knee on the stress film is more than 10 or 10mm. 6. Excellent and good results were obtained in 95.2% by non-surgical management and in 93.0% by surgical management. 7. Early surgical repairs, made within 2 weeks after injury, gave much better results than late repairs.