Recurrent Tibial Tunnel Cyst Formation Following Anterior Cruciate Ligament Reconstruction and Interference Screw Removal

A unique case of a collegiate athlete who suffered an anterior cruciate ligament injury leading to the formation of a synovial cyst is described. The cyst, localized over the tibial tunnel, resulted from irritation caused by the removal of interference screws

Current Best Practice for Management of Medial Collateral Ligament Injury

Abstract: Medical collateral ligament injuries are among the most common knee injuries for the athletic population. Immobilization once was the accepted course of treatment for MCL injuries but research has demonstrated the ineffectiveness of this approach. The knee is second only to the ankle in frequency of injuries in competitive sports and often more severe. Ruptures to the anterior cruciate ligament (ACL) are the most devastating injury to the knee while the medial collateral ligament (MCL) is the most frequently injured (Pickett & Altize, 1971). Although ACL injuries present greater structural deficiency resulting in more time lost when compared to MCL injuries, damage to the MCL is more common. A ruptured MCL often results in considerable structural deficit and may be considered a seasonending injury with return to full activity rates ranging from 4 to 9 weeks (Indelicato, Hermansdorfer, & Huegel, 1989; Jones, Henley, & Francis, 1985). Accepted current practice for treatment and rehabilitation of MCL injuries includes no surgical intervention and a protective hinge brace which allows the knee to flex and extend while limiting medial or lateral stresses on the knee. The brace is removed daily for therapeutic modalities and rehabilitative exercise. However, we have experienced physicians who continue to use immobilization techniques such as long leg casts for management of MCL injuries. This practice precludes appropriate application of modalities and therapeutic exercise and results in delayed recovery time. The purpose of this critical inquiry is to provide best evidence currently available on management of MCL injuries