Good result after surgical treatment of Pellegrini-Stieda syndrome

Knee Surg Sports Traumatol Arthrosc (2009) 17:12311233 DOI 10.1007/s00167-009-0725-0

KNEE

Good result after surgical treatment of PellegriniStieda syndrome

Kanthan Theivendran Caroline J. Lever William J. Hart

Received: 7 September 2008 / Accepted: 16 January 2009 / Published online: 17 February 2009 Springer-Verlag 2009

Abstract Ossication of the femoral attachment of the medial collateral ligament (MCL) of the knee with associated pain and restricted movements is rare and is characteristic of the PellegriniStieda (PS) syndrome. Although in mild cases conservative treatment is often successful, patients with more signicant bone formation and persistent symptoms require surgical excision. We describe a case of PS syndrome with a description of the surgical technique consisting of excision of the bony lesion and reconstruction of the MCL by using the adductor magnus tendon.

Keywords Adductor magnus Knee Medial collateral

ligament Ossication PellegriniStieda

Introduction

Calcication of the origin of the medial collateral ligament (MCL) after history of trauma around the knee is a recognised radiographic nding (PellegriniStieda sign). However, on the rare occasions when this is associated with pain and a restricted range of motion it is known as the PellegriniStieda (PS) syndrome. It was rst clinically described by Pellegrini in 1905 [5] and Stieda then reported the rst series of ve patients in 1908 [8]. There is calcication at the origin of the MCL of the knee with

associated restricted range of movement. Most patients can be successfully treated conservatively with initially rest, anti-inammatory medication and then physiotherapy. Patients who fail conservative treatment may require surgical excision. If left untreated this ossication may potentially form a signicant boney mass resulting in a markedly compromised range of motion.

The exact incidence of PS syndrome is unknown. Males are more often affected than females and the syndrome is rare in children and older adults. The condition is most frequently encountered in patients between the ages of 25 and 40 years [7]. There is little in the literature describing the surgical management of this condition. We describe a case of PS syndrome, the surgical technique for the removal of the lesion and the reconstruction of the MCL.

Case report

A 26-year-old gentleman was involved in a high energy road trafc collision. He was ejected from the car, sustained a signicant head injury and a...