Anatomic MCL repair, reconstruction may have equivalent radiographic results

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Source:

DePhillipo NN, et al. Augmented superficial MCL repair versus reconstruction: a multicenter randomized controlled trial. Presented at the Annual Meeting of the Arthroscopy Association of North America. May 19-21, 2022; San Francisco.


Disclosures: DePhillipo does not report any relevant financial information.


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SAN FRANCISCO – Results presented here have shown that anatomical medial collateral ligament repair and MCL reconstruction may be equivalent based on objective knee laxity, but MCL reconstruction has better subjective outcomes.

Nicholas N. FromPhillipoPhD, ATC, and colleagues randomly assigned 54 patients with grade 3 MCL tears with or without concomitant ACL injuries to undergo either anatomic MCL repair technique with hamstring tendon autograft or complete MCL reconstruction . The researchers considered valgus stress radiographs as the primary outcome variable, which were collected at 6 and 12 months postoperatively.

“A key to our study was that the rehabilitation was almost exactly the same for all patients,” DePhillipo said at the annual meeting of the Arthroscopy Association of North America. “It was out of weight bearing for 6 weeks with a knee immobilizer brace and they were allowed to do early range of motion post-op on day 1. They were limited to 90° flexion at 2 weeks and allowed full range of motion afterwards.”

Nicholas N. DePhillipo

Nicholas N. DePhillipo

Valgus stress x-rays showed no significant difference between the two groups, according to DePhillipo. He said all patients improved significantly from preoperative to postoperative, regardless of the procedure.

“Looking at patient-reported outcomes, Lysholm and IKDC were significantly higher in the MCL reconstruction group, but there were no differences in Tegner or patient satisfaction between the groups,” DePhillipo said.

He said no patient had major complications, such as deep vein thrombosis, infection or arthrofibrosis, and noted that valgus stress x-rays showed no MCL graft failure at least 12 months after the operation.

“We were able to corroborate our biomechanical study and show for the first time the clinical evidence supporting MCL reconstruction or repair with the use of hamstring tendon autograft,” said FromPhillipo. “However, future studies are needed to determine the superiority between the two and this could come down to a number of factors, including cost-effectiveness, operative time and other function and performance outcomes, such as return to Game.”

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