Medial and Posteromedial Instability of the Knee: Evaluation, Treatment, and Results

Background: Posterior and medial knee instability is a significant orthopedic condition resulting from injuries to the internal structures of the knee, particularly the medial collateral ligament (MCL) and the posterior oblique ligament (POL). This instability, which can lead to symptoms such as pain and swelling, severely impacts an individual's functional capabilities and quality of life. It is often observed in athletes who experience acute injuries or repetitive stress injuries. Understanding the mechanisms involved in this type of instability, along with effective assessment methods and treatment options, is crucial for optimal management and rehabilitation. Methods: This study provides a comprehensive review of the literature from ۲۰۱۰ to ۲۰۲۴ on medial and posterior instability, focusing on assessment, treatment strategies, and clinical outcomes. Various diagnostic techniques are discussed, including physical examinations such as the valgus stress test and the dial test, which evaluate knee stability. Imaging methods like MRI are also emphasized due to their role in identifying soft tissue injuries associated with instability. Furthermore, treatment options are categorized into non-surgical methods—such as physiotherapy, bracing, and anti-inflammatory medications—and surgical interventions that may include ligament reconstruction or repair. Results: The findings indicate that medial and posterior instability occurs in approximately ۱۰% to ۲۰% of knee injuries. Patients typically present with symptoms such as pain in the inner joint, a feeling of instability during activity, and reduced range of motion. The injury mechanism often involves varus stress or direct trauma to the knee joint. Non-surgical management includes rest, ice application, compression, elevation (RICE), and targeted physiotherapy aimed at strengthening the muscles around the knee. Surgical intervention may be necessary for high-grade injuries or cases where conservative management fails to provide relief. Additionally, surgical techniques such as arthroscopic ligament reconstruction have shown promising results in restoring stability and function to the knee joint, highlighting that postoperative rehabilitation is essential for regaining strength and mobility while minimizing the risk of recurrence. Conclusion: Medial and posterior knee instability poses significant challenges for diagnosis and treatment due to its association with complex ligament injuries. Early recognition and appropriate management are essential to prevent long-term complications such as chronic pain and functional impairment. While non-surgical treatments may be effective for low-grade injuries, surgical reconstruction may be necessary for more severe cases to effectively restore stability. Continued research into optimal surgical techniques and rehabilitation protocols will enhance outcomes for patients suffering from this debilitating condition.

کلیدواژه ها:

Medial instability ، posteromedial instability ، knee injury ، medial collateral ligament ، rehabilitation strategies