ArticleThe American journal of sports medicine2024
A Comparative Biomechanical Study of Alternative Medial Collateral Ligament Reconstruction Techniques.
Article in The American journal of sports medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 17 citations in OpenAlex.
- Single-Stage Anatomic Reconstruction of Anterior Cruciate Ligament, Posterior Cruciate Ligament, Medial Collateral Ligament, and Posterolateral Corner for Multiligament Knee Injury.Arthroscopy techniques · 2026Article
- Risk of Revision and Patient-Reported Outcomes After ACL Reconstruction: Influence of Concomitant MCL Injury and Graft Choice: Analysis of 35,139 Reconstructions From the Norwegian Knee Ligament Register.The American journal of sports medicine · 2026Article
- Is the Lind or LaPrade Technique Able to Control Anterior and Rotational Laxity in Medial-Side Knee Injuries? A Controlled Laboratory Study of 18 Knees.Orthopaedic journal of sports medicine · 2025Article
- Isn't It Time to Stop Pretending Ligament Reconstructions Are "Anatomic"?Sports health · 2025Article
- Which tibial implantation site for the deep medial collateral ligament should be chosen to control anteromedial rotatory instability of the knee?Journal of experimental orthopaedics · 2025Article
- Reconstruction of the Medial Collateral Ligament and the Posterior Oblique Ligament With a Flat Tibialis Allograft: the "Trifid Flat Reconstruction".Arthroscopy techniques · 2025Article
- Double-Bundle Femoral-Based Reconstruction of the Deep and Superficial Medial Collateral Ligament for Anteromedial Rotatory Instability: The MAVERIK Technique.Arthroscopy techniques · 2025Article
- Current trends in the medial side of the knee: not only medial collateral ligament (MCL).Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2024Review
- A Flat Reconstruction of the Medial Collateral Ligament and Anteromedial Structures Restores Native Knee Kinematics: A Biomechanical Robotic Investigation.The American journal of sports medicine · 2024Article
- A novel minimally invasive nonanatomical single-bundle medial collateral ligament reconstruction technique with a short isometric construct Achilles tendon allograft: A surgical description with clinical and radiological outcomes in multiligament knee injury patients.Journal of experimental orthopaedics · 2024Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is little evidence of the biomechanical performance of medial collateral ligament (MCL) reconstructions for restoring stability to the MCL-deficient knee regarding valgus, external rotation (ER), and anteromedial rotatory instability (AMRI). HYPOTHESIS: A short isometric reconstruction will better restore stability than a longer superficial MCL (sMCL) reconstruction, and an additional deep MCL (dMCL) graft will better control ER and AMRI than single-strand reconstructions. STUDY
designControlled laboratory study.
methodsNine cadaveric human knees were tested in a kinematics rig that allowed tibial loading while the knee was flexed-extended 0° to 100°. Optical markers were placed on the femur and tibia and displacements were measured using a stereo camera system. The knee was tested intact, and then after MCL (sMCL + dMCL) transection, and loaded in anterior tibial translation (ATT), ER, varus-valgus, and combined ATT + ER (AMRI loading). Five different isometric MCL reconstructions were tested: isolated long sMCL, a short construct, each with and without dMCL addition, and isolated dMCL reconstruction, using an 8 mm-wide synthetic graft.
resultsMCL deficiency caused an increase in ER of 4° at 0° of flexion (
conclusionAll tested techniques apart from the isolated long sMCL graft are satisfactory in the context of restoring the valgus, ER, and AMRI stability to the MCL-deficient knee in a cadaveric model. CLINICAL RELEVANCE: Contemporary MCL reconstruction techniques fail to control ER and therefore AMRI as they use a long sMCL graft and do not address the dMCL. This study compares 5 MCL reconstruction techniques. Both long and short isometric constructs other than the long sMCL achieved native stability in valgus and ER/AMRI. Double-strand reconstructions (sMCL + dMCL) tended to provide more stability. This study shows which reconstructions demonstrate the best biomechanical performance, informs surgical reconstruction techniques for AMRI, and questions the efficacy of current popular techniques.
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