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Early medial reconstruction combined with severely injured medial collateral ligaments can decrease residual medial laxity in anterior cruciate ligament reconstruction

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

This study aimed to describe an anatomic medial knee reconstruction technique for combined anterior cruciate ligament (ACL) and grade III medial collateral ligament (MCL) injuries and to assess knee function and stability restoration in patients who underwent primary MCL reconstruction compared with primary repair.

Methods

A total of 105 patients who had undergone anatomic ACL reconstruction between 2008 and 2017 were enrolled in this retrospective study and divided into two groups according to concomitant MCL ruptures. Group A included patients with isolated ACL ruptures without MCL injuries. Group B included patients with both ACL and MCL injuries, and it was subdivided into three groups according to the severity of the MCL injury and treatment modality: B-1, grade I or II MCL injury treated conservatively; B-2: grade III MCL injury treated by primary MCL repair; and B-3: grade III MCL injury treated by primary reconstruction. Knee stability was measured via Telos valgus radiography at 6-month and 2-year postoperative. The Lysholm score, Tegner activity level, Likert scales (satisfaction), and return to previous sports were evaluated at 2-year postoperative.

Results

At 6-month postoperative, there was no significant difference in medial laxity between the B-2 and B-3 groups. However, at 2-year postoperative, medial laxity were significantly higher both at 30° of flexion (5.2° versus 2.2°, p = 0.020) and at full extension (3.4° versus 1.1°, p < 0.001) in patients in B-2 group compared to those in B-3 group. There were no statistically significant differences between the two groups with respect to Lysholm scores, Tegner activity levels, Likert scales (satisfaction), and returning to previous sports at the 2-year follow-up.

Conclusion

Primary medial reconstruction combined with severely injured MCL in ACL reconstruction may decrease residual medial laxity more than primary repair.

Level of evidence

Retrospective observational study, IV.

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Acknowledgements

This work was supported by the Gachon University research fund of 2021 (GCU-2021-07290001).

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Authors and Affiliations

  1. Department of Orthopaedics Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea

    Jae Ang Sim, Young Gon Na, Ji Wook Choi & Byung Hoon Lee

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  1. Jae Ang Sim
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Contributions

(1) Conception and design of the study (JAS, BHL), data collection (JWC), data analysis and interpretation (BHL), (2) drafting the manuscript (BHL), critically revising the manuscript for important intellectual content (BHL, JAS), and (3) final approval of the version to be submitted (all authors). BHL (oselite@naver.com) is responsible for the integrity of this work.

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Correspondence to Byung Hoon Lee.

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Sim, J.A., Na, Y.G., Choi, J.W. et al. Early medial reconstruction combined with severely injured medial collateral ligaments can decrease residual medial laxity in anterior cruciate ligament reconstruction. Arch Orthop Trauma Surg 142, 2791–2799 (2022). https://doi.org/10.1007/s00402-021-04211-5

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