2023 ISAKOS Biennial Congress Paper
Comparative Study Of Superficial Medial Collateral Ligament Reconstruction Combined With Posterior Oblique Ligament Reconstruction Or Posteromedial Capsule Advance In Grade III Injuries Of The Medial Compartment In A Complex Knee Injury Scenario
Camilo P. Helito, MD, PhD, Prof, São Paulo, SP BRAZIL
Andre Giardino Moreira Da Silva, MD, São Paulo, São Paulo BRAZIL
Marcel F. Sobrado, MD, PHD, São Paulo, SP BRAZIL
Pedro N. Giglio, MD, São Paulo, SP BRAZIL
Riccardo Gomes Gobbi, MD, PhD, São Paulo, SP BRAZIL
José R. Pécora, Prof., São Paulo, SP BRAZIL
University of São Paulo, São Paulo, São Paulo, BRAZIL
FDA Status Cleared
Summary
Both techniques present good functional results and a low rate of complications. However, the advancement technique showed greater flexion loss, which should be considered when choosing the best surgical option.
Abstract
Introduction
The purpose of this study is to compare the combined reconstruction of the superficial medial collateral ligament (sMCL) and the posterior oblique ligament (POL) with the reconstruction of the sMCL associated with the advancement of the posteromedial capsule in a complex knee injury scenario. We hypothesize that both techniques will present similar knee stability and failure rates.
Methods
This is a retrospective case-control study designed to compare the results of the two reported techniques for grade III MCL instability. Patients undergoing MCL reconstruction associated with anterior cruciate ligament, posterior cruciate ligament or both, from 2010 to 2019, were included. The following parameters were evaluated: demographic data, type of graft, time from injury to surgery, associated meniscus injuries, follow-up time, mechanism of trauma, post-operative objective IKDC, subjective IKDC and Lysholm scales, range of motion, reconstruction failure and complications.
Results
78 patients were evaluated. 37 of whom underwent reconstruction of the sMCL and POL, and 41 underwent reconstruction of the sMCL with advancement of posteromedial structures. There was no difference in any pre-operative variable. Patients undergoing reconstruction of the sMCL + advancement had greater loss of flexion (Group 1 3.4±4.6 vs. Group 2 8.4±7.9; p=0.002) and more individuals with flexion loss greater than 10º (Group 1 seven patients (18.9%) vs. Group 2 17 patients (41.5%); p=0.031). Post-operative knee stability, failures and complications were similar between groups.
Conclusion
Both techniques present good functional results and a low rate of complications. However, the advancement technique showed greater flexion loss, which should be considered when choosing the best surgical option.