ArticleOrthopaedic journal of sports medicine2025
Evaluation of the Stability, Revision Rate, and Complication Profile of Combined Anterior Cruciate Ligament Reconstruction with Lateral Extra-Articular Tenodesis and Hughston Procedure in Anterior Cruciate Ligament and Medial Collateral Ligament Injury: An 8-Year Cohort Study.
Article in Orthopaedic journal of sports medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline 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
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9 authors.
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Abstract
Background: Anterior cruciate ligament (ACL) tears combined with medial collateral ligament (MCL) injury has been associated with an increased rate of ACL reconstruction (ACLR) failure, high-grade pivot shift (PS), and lower return to sports rate. On the other hand, medial-sided procedures in the setting of ACLR are associated with knee stiffness and arthrofibrosis. Purpose/Hypothesis: This study aimed to compare clinical scores, objective knee laxity, failure, and complication rates in 2 different patient groups. The combination of ACL reconstruction with LET and the Hughston procedure yields comparable failure rates, complication rates, and clinical outcomes to ACL reconstruction with LET in patients without medial instability. Study Design: Cohort study; Level of evidence, 3. Methods: A group of patients had a combined ACL and MCL injury grade 2 with chronic instability and underwent ACLR associated with lateral extra-articular tenodesis (LET) and the Hughston procedure (Hughston group). The control group included matched patients with isolated ACL lesion without medial instability who underwent ACL reconstruction with LET (control group). Patient-reported outcome measures, complications, and reoperations were collected for both groups. A clinical evaluation was performed including objective anteroposterior laxity measurement (KT-1000 arthrometer) and PS quantification. The primary outcomes were ACL revision and ACL-clinical failure, a composite parameter of anteroposterior and rotatory laxity. A test for 2-way analysis of variance for repeated measures was performed to assess the between-group differences ( Results: A total of 70 patients (35 per group) were enrolled in the present study at a follow-up of 8.1 ± 2.7 years. All the patient-reported outcome measures significantly improved at the final follow-up with no difference between the 2 groups ( Conclusion: Due to its simplicity and cost-effectiveness, the Hughston technique should be included in the orthopaedic surgeon's armamentarium for the treatment of moderate anteromedial instability in combined ACL and MCL injury. Moreover, the outcomes and failure rate of the Hughston technique combined with an ACLR + LET are similar to that of an ACLR + LET used to treat an isolated ACL injury.
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