Can status of superficial medial collateral ligament proximal tibial attachment predict progression of OA knee?

Objective: This study aims to identify, whether knee OA progression is affected by the sMCL proximal tibial attachment status and probably is the first one trying to identify such association. Methods: 90 OA knees and 80 normal knees were evaluated using radiographs and MRI for severity of OA knee (K-L grade), sMCL length (L), distance of distal tibial attachment of sMCL from tibial articular surface (I), MCL ratio (L/I) and proximal tibial attachment of sMCL, attached or detached. Results: Mean age of the study population was 52.93 ± 19.52 years. 106 were female knees and 59 were male. Status of sMCL proximal tibial attachment had highly statistically significant negative correlation with severity of OA knee (p-value <0.001). The status of sMCL proximal tibial attachment shows statistically significant negative correlation with sMCL distal tibial attachment and significant positive correlation MCL ratio. But there was no significant correlation with sMCL length. Knees with lower MCL ratio (L/I) have significant higher grade of OA knee as they shows statistically significant negative correlation. Conclusion: Detached sMCL proximal tibial attachment is found to be a strong predictor of OA knee progression. Assessing the status of sMCL proximal tibial attachment will not only help the physician identifying medial stability of the knee, but also assist in planning therapy for the knee in question.