ArticleBMC musculoskeletal disorders2026
Clinical and cadaveric evidence for inlay technique fixation in ruptured MCL inferior attachment treatment.
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAlthough well-documented for ligament graft fixation, the inlay technique remains largely unexplored for distal MCL avulsions, presenting a significant opportunity. A comprehensive evaluation of this approach utilizing an interference screw is now demanded, focusing on its biomechanical properties, kinematic influence, and ultimate clinical efficacy.
methodsThe MCL dynamic trajectories were recorded during full range of motion in three cadaveric specimens, and the mechanical strength were compared between inlay and onlay techniques using isokinetic tensile tests. Twenty-six patients with ruptured MCL inferior attachments underwent inlay technique fixation surgery 2 cm proximal to the distal insertion. Lateral stress tests, knee joint Lysholm scores, and MRIs used to evaluate knee stability and function.
resultsMCL dynamic trajectories showed no displacement within 3 cm of the ligament’s distal end during full range of motion. Inlay technique exhibited significantly higher mechanical strength and shorter displacement compared to onlay technique. Twenty-six patients underwent this surgical technique, with negative lateral stress and drawer tests post-operation. Knee joint Lysholm scores significantly increased from 30 (17,48) pre-operation to 65 (30,90) at 3 months, 81 (60,95) at 6 months, and 90 (83,95) at 12 months post-operation (P < 0.05). MRI results showed satisfactory tendon-bone healing and ligament tension.
conclusionsInlay technique offers superior mechanical strength, earlier stability and tendon-bone healing for treating the inferior attachment of the MCL. An upward shift of the MCL insertion point within 3 cm does not impair knee joint motion trajectory.
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