ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025
MCL augmentation using a peroneus longus split tendon autograft satisfactorily restores knee stability with no impairment in foot function and with a low failure rate for concurrent ACL reconstruction.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Operative treatment of high-grade medial collateral ligament injury and chronic medial knee instability: a systematic review.Archives of orthopaedic and trauma surgery · 2026Pooled it
- A systematic review of distal medial collateral ligament Stener-like lesion: Good clinical and functional outcomes of surgical treatment.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Pooled it
- Single-strand superficial medial collateral ligament reconstruction with a peroneus longus split graft provides reliable control of anteromedial rotatory instability combined with anterior cruciate ligament reconstruction: A 2-year clinical cohort study.Journal of experimental orthopaedics · 2026Article
- Knee and ankle functional outcome after anterior cruciate ligament reconstruction with a peroneus longus tendon autograft : A prospective clinical study.Orthopadie (Heidelberg, Germany) · 2026Article
- Delayed Simultaneous Reconstruction of the ACL and MCL Using Ipsilateral Single Hamstring Tendon Autograft With A Modified Technique.Orthopaedic surgery · 2026Article
- [Comparative study of different treatment methods for peroneus longus tendon stump in anterior cruciate ligament reconstruction].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025Article
- MCL augmentation using a peroneus longus split tendon autograft satisfactorily restores knee stability with no impairment in foot function and with a low failure rate for concurrent ACL reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
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Authors and funding
8 authors.
Funding
Abstract
purposeAddressing grade 2 and 3 medial-sided instabilities during anterior cruciate ligament (ACL) reconstruction is crucial to reduce the risk of ACL graft failure. This study introduced a minimally invasive, medial collateral ligament (MCL) augmentation technique using a peroneus longus split tendon autograft, which was fixed to the femoral deep MCL insertion and tibial superficial MCL insertion.
methodsThis prospective, longitudinal, single-centre case series included patients who underwent MCL augmentation concurrent with primary or revision ACL reconstruction due to anteromedial instability. Preoperatively and at 1-year follow-up, clinical examinations, such as rolimeter test of anterior tibial translation and medial instability, knee (International Knee Documentation Committee subjective knee form [IKDC], Lsyholm, Knee Injury and Osteoarthritis Outcome Score [KOOS]) and foot function scores (American Orthopaedic Foot and Ankle Society score [AOFAS]) and complications, were analyzed.
resultsThirty-one patients with a mean follow-up of 13.5 ± 2.6 months and a mean age of 27.8 ± 9.6 years were included. The side-to-side difference for anterior tibial translation significantly improved from preoperative to 1-year follow-up with an ACL reconstruction failure rate of 6.5%. No patient retained a grade 2 or 3 medial instability on valgus stress testing with 30° flexion. Significant improvements from preoperative to 1-year postoperative follow-up were observed in knee function scores: IKDC (48.9 ± 26.9- 71.3 ± 11.5, p < 0.001) and Lysholm (59.9 ± 28.5-80.5 ± 11.2, p = 0.002) as well as KOOS pain, ADL, sport and QoL, each reaching the respective minimal clinically important difference values. The foot function score AOFAS showed no significant impairment (100 ± 0-99.3 ± 2.5, p = 0.250). Complications included cyclops lesions of ACL reconstruction in three patients.
conclusionAt 1-year follow-up, MCL augmentation using a peroneus longus split tendon autograft for patients simultaneously undergoing ACL reconstruction satisfactorily restores knee stability, has a low ACL reconstruction failure rate and does not significantly impair foot function. LEVEL OF EVIDENCE: Level IV therapeutic study; case series.
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