Related Experiment Video
Updated: Dec 23, 2025
05:07
Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
2.5K
Single-bundle MCL reconstruction with anatomic single-bundle ACL reconstruction does not restore knee kinematics
Weimin Zhu1,2, Junjun Zhu3, Brandon Marshall3
1Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, Suite 1010, Kaufmann Building, Pittsburgh, PA, 15213, USA.
Summary
Single-bundle medial collateral ligament (MCL) reconstruction with ACL repair does not restore knee stability. Double-bundle or modified triangular MCL reconstruction, combined with ACL repair, can restore normal knee kinematics and stability.
Area of Science:
- Orthopedic surgery
- Biomechanical analysis
- Sports medicine
Background:
- Combined anterior cruciate ligament (ACL) and superficial medial collateral ligament (sMCL) injuries are common in knee trauma.
- Restoring knee kinematics and kinetics after combined injuries is crucial for functional recovery.
- Current surgical techniques for sMCL reconstruction vary, impacting clinical outcomes.
Purpose of the Study:
- To compare knee kinematics and kinetics after single-bundle (SB), modified triangular, or double-bundle (DB) sMCL reconstruction combined with SB anatomic ACL reconstruction.
- To evaluate the effectiveness of different sMCL reconstruction techniques in restoring knee stability.
Main Methods:
- A cadaveric knee model (n=10) was used to simulate intact, deficient, and reconstructed knee states.
- Knee kinematics and kinetics were assessed under anterior tibial load, internal/external rotation, and valgus torque.
- Three sMCL reconstruction techniques (SB, DB, modified triangular) were compared with SB anatomic ACL reconstruction.
Main Results:
- SB MCL reconstruction with ACL repair restored anterior tibial translation and external rotation but not internal rotation or valgus stability.
- Both DB MCL and modified triangular MCL reconstructions, with ACL repair, restored all tested knee kinematics to intact levels.
- DB MCL reconstruction showed slightly better biomechanical stability than modified triangular MCL reconstruction.
Conclusions:
- Single-bundle MCL reconstruction with single-bundle ACL reconstruction is insufficient for restoring knee kinematics in combined injuries.
- Anatomical double-bundle MCL reconstruction may offer superior biomechanical stability compared to modified triangular reconstruction.
- Modified triangular MCL reconstruction presents a potentially more practical, less invasive, and simpler alternative that restores near-normal knee function.
Keywords:
ACL reconstructionKnee kinematicsMCL reconstructionPosterior oblique ligamentSuperficial MCL
