A new surgical technique for medial collateral ligament balancing: multiple needle puncturing

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Knee Ligament Reconstruction

Background:

• Medial knee tightness can complicate knee surgeries, particularly in varus knees.
• Accurate medial soft tissue balancing is crucial for successful surgical outcomes.
• Existing techniques for medial collateral ligament (MCL) manipulation may lack precision or control.

Purpose of the Study:

• To present a novel technique for medial soft tissue balancing using needle puncturing of the MCL.
• To evaluate the effectiveness and safety of this new technique for correcting MCL tightness.
• To establish criteria for successful ligament balancing using this method.

Main Methods:

• A new technique involving multiple 19-gauge needle punctures in the MCL was employed for progressive stretching.
• Computer navigation and mediolateral stress testing were used to assess ligament status before and after the procedure.
• Success was defined by achieving specific mediolateral joint line opening measurements in extension and flexion.

Main Results:

• The needle puncturing technique successfully achieved progressive correction of medial tightness in 34 out of 35 cases.
• The procedure met the defined criteria for correct ligament balance in the majority of patients.
• One case experienced an over-release in extension, indicating a need for careful application.

Conclusions:

• Needle puncturing is a novel, effective, and safe method for the progressive correction of MCL tightness.
• This technique allows for precise control over medial soft tissue balancing in varus knee procedures.
• The study supports the use of needle puncturing as a valuable tool in knee ligament surgery.