A New Surgical Technique for Medial Collateral Ligament Balancing

Multiple Needle Puncturing

Johan Bellemans, MD, PhD, Hilde Vandenneucker, MD, Johan Van Lauwe, MD, and Jan Victor, MD

The Journal of Arthroplasty Vol. 00 No. 0 2010

Abstract: In this article, we present our experience with a new technique for medial soft tissue balancing, where we make multiple punctures in the medial collateral ligament (MCL) using a 19-gauge needle, to progressively stretch the MCL until a correct ligament balance is achieved.

Ligament status was evaluated both before and after the procedure using computer navigation and mediolateral stress testing. The procedure was considered successful when 2 to 4-mm mediolateral joint line opening was obtained in extension and 2 to 6 mm in flexion. In 34 of 35 cases, a progressive correction of medial tightness was achieved according to the above described criteria.

One case was considered overreleased in extension. Needle puncturing is a new, effective, and safe technique for progressive correction of MCL tightness in the varus knee.