AJSM February 2024 Podcast: Nonoperative Management, Repair, or Reconstruction of the Medial Collateral Ligament in Combined Anterior Cruciate and Medial Collateral Ligament Injuries—Which Is Best? A Systematic Review and Meta-analysis
Combined injury of the anterior cruciate
ligament (ACL) and the medial collateral ligament (MCL) is a common
injury pattern and accounts for 20% of all ligamentous knee
injuries. Despite advancements in surgical technique, there is no
up-to-date consensus regarding the superiority of nonoperative
versus operative management in higher-grade MCL tears of combined
ACL-MCL injuries.
In conclusion, reconstruction of combined
injury in a delayed fashion facilitates return of range of motion
and may allow time for low-grade MCL tears to heal. If residual
valgus or anteromedial rotatory laxity remains after a period of
rehabilitation, then concomitant surgical management of ACL and MCL
injuries is warranted. Avulsion MCL injuries and Stener-type
lesions may benefit from early repair techniques.
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