Treatment of Combined Injuries to the ACL and the MCL Complex: A Consensus Statement of the Ligament Injury Committee of the German Knee Society (DKG)

Abstract

Background: Different indications and treatment options for combined injuries to the anterior cruciate ligament (ACL) and medial collateral ligament complex (MCL) are not clearly defined. Purpose: To perform a modified Delphi process with the Committee for Ligament Injuries of the German Knee Society (DKG) in order to structure and optimize the process of treating a combined injury to the ACL and MCL. Study Design: Consensus statement. Methods: Scientific questions and answers were created based on a comprehensive literature review using the central registers for controlled studies of Medline, Scopus, and Cochrane including the terms medial collateral ligament, anterior cruciate ligament, MCL, ACL, and outcome used in various combinations. The obtained statements passed 3 cycles of a modified Delphi process during which each was readjusted and rated according to the available evidence (grades A-E) by the members of the DKG Ligament Injuries Committee and its registered guests. Results: The majority of answers, including several questions with >1 graded answer, were evaluated as grade E (n = 16) or C (n = 10), indicating that a low level of scientific evidence was available for most of the answers. Only 5 answers were graded better than C: 3 answers with a grade of A and 2 answers with a grade of B. Only 1 answer was evaluated as grade D. An agreement of >80% (range, 83%-100%) among committee members was achieved for all statements. Conclusion: The results of this modified Delphi process offer a guideline for standardized patient care in cases of combined injuries to the ACL and MCL.

Effect of Rehabilitation Physical Training on PE Teaching Sports Injury under Ultrasonic Examination

“…The balance ability reflects the stability of lower limbs by standing on one foot with eyes closed. Lower limb explosive force is tested by the CMJ mode of a single-leg Counter Movement Jump, and the data are collected by the MYOTEST explosive force tester [14]. 3 Scanning evaluating the training effect of each stage, so as to ensure the quality of rehabilitation training for patients [15].…”

“…The balance ability reflects the stability of lower limbs by standing on one foot with eyes closed. Lower limb explosive force is tested by the CMJ mode of a single-leg Counter Movement Jump, and the data are collected by the MYOTEST explosive force tester [ 14 ].…”

Nachbehandlung nach Knorpeltherapie am Kniegelenk – eine Empfehlung der AG Klinische Geweberegeneration der DGOU

“…As part of a consensus procedure, a multi-stage member survey was conducted, as has already been used in other consensus procedures [3,5]. As part of the first survey, an appraisal and a description of the current situation were first collected.…”

“…As part of this recommendation, a multi-stage survey was conducted to prioritise and prepare the final statements. This type of consensus formation has also been used in other studies in the past and appears suitable for a problem-orientated approach involving several participants [3,5].…”

Dynamic Ultrasound Can Accurately Quantify Severity of Medial Knee Injury: A Cadaveric Study

“… 1 , 9 , 10 Inadequately treated medial knee injures may lead to persistent instability, which in turn may result in failure of meniscal repairs and cruciate reconstructions, in addition to articular cartilage damage. 11 , 12 Thus, accurate diagnosis of the severity and management of medial knee injuries is critical.…”