Extracorporale shockwavetherapie bij een calcificatie van het mediale collaterale knieligament: een casus met literatuurnazicht

Abstract

Extracorporeal shock wave therapy as a treatment for medial collateral knee ligament calcification: case presentation and overview of the literature Background Calcification of the medial collateral ligament is an uncommon cause of medial knee pain. In the few case reports that have been written, in multiple cases various conservative treatments have been assessed, often with an unsatisfactory result, leading to the excision of the toothpaste-like calcification. The conservative treatment consists of a short period of ice, analgesics or anti-inflammatory drugs, physiotherapy, a local corticosteroid injection or ultrasound-guided lavage. Case presentation A 40-year-old man with recurring medial knee pain since 2 years was diagnosed with medial collateral ligament calcification of the right knee. The pain was located near the medial epicondyle of the femur. The range of motion was maximal with painful knee flexion and moderate tenderness at the proximal medial collateral ligament. The pain started after a bicycle crash and the diagnosis was made by means of an MRI. Initially, the pain briefly improved after a local corticosteroid injection and physiotherapy, but reoccurred during running. The subsequent physical examination and ultrasound confirmed the diagnosis. The treatment consisted of a combination of physiotherapy and extracorporeal shock wave therapy, performed twice with an interval of 71 days. The follow-up after 5 months revealed that the patient had regained optimal knee function and was pain free at rest and during running. Conclusion Symptomatic medial collateral ligament calcification is a rarely diagnosed condition, mostly treated surgically without adequate conservative therapy. This case report suggests that conservative therapy consisting of physiotherapy and extracorporeal shock wave therapy can be successful in treating medial collateral ligament calcification.