Nonsurgical Management and Postoperative Rehabilitation of Medial Instability of the Knee

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The medial ligaments of the knee are the most frequently injured structures of the knee joint. The decisions regarding the treatment of medial knee injuries must take into account the severity of injury to the entire knee, the chronicity of the injury, and the patient goals and activity level. The treatment and rehabilitation of the medial structures of the knee is largely reliant on the healing potential of these structures. Studies have shown that these medial, extra-articular ligaments may possess the ability to heal by both intrinsic and extrinsic properties. The goals of nonoperative treatment should include healing of the injured medial structures while controlling edema, restoring full knee motion, and preserving muscle strength. In cases of continued medial instability after an isolated grade III injury or in cases of combined multiligamentous knee injuries, the medial structures of the knee may be treated operatively with repair or reconstruction. The goals of rehabilitation following surgical intervention are the same as for nonoperative treatment; however, the progression of activity is more gradual to allow for repaired or reconstructed tissue to heal. If the objectives of early edema control, restoration of knee motion, gradual resumption of weight bearing, and return of muscle strength are followed, patients should return to full activity following medial injuries to the knee.

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