2025 ISAKOS Congress in Munich, Germany

2025 ISAKOS Biennial Congress Paper


Nonoperative Management of Medial Collateral Ligament Injury in Combined Anterior Cruciate Ligament Reconstruction Provides Satisfactory Clinical Outcomes at 2 Year Follow Up

Jihoon Bae, MD, PhD, Seoul KOREA, REPUBLIC OF
Ppuri Bak, MD, Seoul KOREA, REPUBLIC OF
Jeongho Son, MD, Seoul KOREA, REPUBLIC OF

KOREA UNIVERSITY GURO HOSPITAL, SEOUL, KOREA, REPUBLIC OF

FDA Status Not Applicable

Summary

Nonoperative treatment for MCL injuries combined ACL reconstruction is an effective treatment

Abstract

Background

There is a need for an increased understanding of the way that a concomitant medial collateral ligament (MCL) injury may influence outcome after anterior cruciate ligament (ACL) reconstruction. The purposes of this study were to investigate the clinical results of nonoperative management of concomitant MCL injury to ACL reconstruction (ACLR) and to compare those results with those results of isolated ACL reconstruction without a MCL injury.
 

Methods

A total of 138 patients (Male 112, mean age 28.4 years old) were included by the study criteria. The patients were classified as 2 groups whether MCL injury was combined. ACL-MCL injury was Group 1 (n=27), and isolated ACL injury was Group 2 (n=111). 2-year clinical outcomes included patient-reported outcomes (PROM- Lysholm score, Tegner activity level, and IKDC 2000 subjective score), Quadriceps/Hamstring muscle strength deficit, return to sports (RTS) and graft maturation. We asked patients if they returned to the any type of sports at 2-year after ACLR. The healing status of ACL graft was evaluated on second-look arthroscopy using four parameters: graft continuity, tension, synovial coverage, and vascularization. Those parameters were compared between two groups. Statistical significance was set at p-value < 0.05.
 

Results

At 2-year follow-up, no significant differences of Lysholm score (81 vs 82; p=.816), Tegner activity level (7.4 vs 6.8; p=.366), IKDC 2000 subjective score (74 vs 78; p=.285), quadriceps strength deficit (13.4% vs 12.1%; p=.792), hamstring strength deficit (10.2% vs 6.6%; p=.363), and rates of return to sports (78% vs 82%; p=.365) were observed between group 1 and 2. On the second-look arthroscopic examination, only graft tension parameter (1.2 vs 1.6; P=.028) showed significant difference, but graft continuity (1.2 vs 1.6; p=.453), synovial coverage (1.1 vs 1.5; p=.151), vascularization (1.0 vs 1.1; p=.652) parameters and KUMC graft maturation score (5.4 vs 5.9; p=.075) showed no significant difference. During the study period, there were no complications and revision surgeries in both groups.

Conclusion

Nonoperative treatment for MCL injuries combined ACL reconstruction is an effective treatment and provides similar clinical outcomes to those of isolated ACL reconstruction without an MCL injury.