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Application of triangular vector to functionally reconstruct the medial collateral ligament with double-bundle

Jiang Tao Dong1, Bai Cheng Chen, Xiao Qian Men

  • 1Department of Orthopaedics, Third Hospital, Hebei Medical University, Shijiazhuang, China.

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|July 17, 2012
PubMed
Summary

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This study introduces a novel triangular double-bundle allograft technique for medial collateral ligament (MCL) reconstruction. The procedure effectively improved knee stability and patient outcomes, showing similar results for isolated MCL injuries versus combined MCL-anterior cruciate ligament injuries.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Knee Biomechanics

Background:

  • Medial collateral ligament (MCL) injuries often lead to knee instability.
  • Current MCL reconstruction techniques vary in effectiveness for restoring valgus and rotational stability.
  • Combined MCL and anterior cruciate ligament (ACL) injuries present unique reconstructive challenges.

Purpose of the Study:

  • To introduce a novel triangular double-bundle allograft technique for MCL reconstruction.
  • To evaluate the clinical outcomes and efficacy of this new surgical procedure.
  • To compare outcomes between isolated MCL injuries and combined MCL-ACL injuries.

Main Methods:

  • A series of 56 patients with medial knee instability underwent MCL reconstruction using a triangular double-bundle allograft.

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  • Patients were categorized into isolated MCL injury (27) or combined MCL-ACL injury (29) groups.
  • Clinical assessments included International Knee Documentation Committee (IKDC) scores, anteromedial rotatory instability (AMRI), and excessive knee medial opening (EKMO) preoperatively and postoperatively.

    • Main Results:

    • Significant reductions in EKMO (10.1 mm to 2.9 mm) and AMRI (67.9% to 9.4%) were observed postoperatively.
    • High rates of excellent or good IKDC subjective scores (58.9% Grade A, 35.7% Grade B) were achieved.
    • No significant differences in IKDC scores, AMRI, or EKMO were found between isolated MCL and combined MCL-ACL injury groups, though knee extension deficits differed.

    Conclusions:

    • The novel triangular double-bundle allograft technique effectively reconstructs the MCL, improving valgus and rotational stability.
    • Short-term clinical outcomes, assessed by IKDC scores, indicate successful treatment for medial knee instability.
    • The technique demonstrates comparable efficacy for both isolated MCL injuries and combined MCL-ACL injuries.