Good clinical outcome of nonoperatively treated low grade medial collateral ligament injuries combined with primary anterior cruciate ligament reconstruction
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: The purpose of this study was to determine whether functional outcomes differ between patients undergoing an anterior cruciate ligament (ACL) reconstruction with a concomitant, nonoperatively treated grade I and II medial collateral ligament (MCL) injury (ACL + MCL group) and those undergoing an isolated ACL reconstruction (ACL group). METHODS: A total of 153 patients (34 ACL + MCL group, 119 ACL group, mean age: 28.6 years) who were available for a 2-year follow-up without re-injuries or requiring revision were included in this study. Preoperative magnetic resonance imaging was used to diagnose the MCL injury and a grade of MCL laxity was evaluated by physical examination. Patient-reported outcomes (the Lysholm score, the Tegner activity score, the International Knee Documentation Committee subjective knee form score [IKDC 2000], the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Anterior Cruciate Ligament-Return to Sport after Injury scale (ACL-RSI), and return to pre-injury level of sports activity at 2 years after ACL reconstruction were compared between the two groups. Statistical significance was set at a p-value <0.05. RESULTS: At the 2-year follow-up, no statistically significant differences of Lysholm score (84.7 vs 83.2; p = 0.740), Tegner activity score (6.2 vs 6.3; p = 0.829), IKDC 2000 subjective score (77.1 vs 78.9; p = 0.572), KOOS symptom (81 vs 78.5; p = 0.454); pain (90.1 vs 93.6, p = 0.513), daily living (96.4 vs 94.5; p = 0.172), sports and recreation (80.5 vs 77.2; p = 0.352), quality of life (39.2 vs 43.1; p = 0.172), ACL-RSI emotion (53.4 vs 53.7; p = 0.953); confidence (63 vs 63.1; p = 0.970); risk (55.6 vs 52.5; p = 0.565) and ACL-RSI total (58.5 vs 57; p = 0.679) were observed. There were no statistically significant differences of rates of return to pre-injury level of sports activity (44% vs 29%, p = 0.092). CONCLUSION: Similar patient-reported, functional, and return-to-sport outcomes were found for nonoperatively treated grade I and II MCL injuries combined with ACL reconstruction compared to those of isolated ACL reconstruction at the 2-year follow-up. LEVEL OF EVIDENCE: Level III, retrospective cohort study.
Authors: Ji Hoon Bae, Ppuri Bak, Jeongho Son
Institution: Korea University Guro Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,000
OpenAlex ID: W4417443783