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Updated: Sep 13, 2025

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Allograft Use in Peripheral Knee Ligament Injuries (MCL and LCL): A Systematic Review.

Vasileios S Akrivos1, Nifon Gkekas1, Ilias Chantes2

  • 1Department of Orthopaedic Surgery and Musculoskeletal Trauma, University Hospital of Larissa, School of Health Sciences, University of Thessaly,  Larissa, Greece.

Sports Medicine and Arthroscopy Review
|August 1, 2025
PubMed
Summary

This review found that allografts provide satisfactory outcomes for medial collateral ligament (MCL) and posterolateral corner (PLC) knee reconstructions, improving stability and function. However, graft failure rates were notable, particularly for LCL/PLC procedures.

Keywords:
AllograftsKnee ReconstructionLCLMCLPLC

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomaterials in Reconstruction

Background:

  • Limited comprehensive studies exist on exclusive allograft use for MCL and PLC reconstruction.
  • Allografts are increasingly considered for ligamentous knee reconstructions.
  • Assessing allograft efficacy for MCL and PLC is crucial for clinical decision-making.

Purpose of the Study:

  • To systematically review and assess clinical and functional outcomes of allograft use in MCL and PLC reconstruction.
  • To analyze stability, functional scores, and complication rates associated with allograft ligament reconstruction.
  • To provide evidence-based insights into the efficacy of allografts for knee ligament repair.

Main Methods:

  • Systematic literature search following PRISMA guidelines across major databases (PubMed, MEDLINE, Scopus, etc.).
  • Analysis of 19 studies (547 patients) for LCL/PLC and 5 studies (135 patients) for MCL reconstructions using allografts.
  • Evaluation of outcomes including stability, IKDC, Lysholm scores, Tegner, Cincinnati Knee Rating System, Marx score, complications, and graft failure.

Main Results:

  • LCL/PLC reconstruction with Achilles tendon allografts showed significant improvement in lateral opening, IKDC, and Lysholm scores, with an 11.13% failure rate and 19.75% complication rate.
  • MCL reconstruction with allografts demonstrated reduced medial opening and improved IKDC and Lysholm scores, with a 4.19% failure rate and 10.93% complication rate.
  • Allograft use resulted in stable and functional knees for both LCL/PLC and MCL reconstructions.

Conclusions:

  • Allografts yield satisfactory clinical and functional outcomes for LCL, PLC, and MCL knee reconstructions.
  • While effective, a relatively high graft failure rate necessitates careful consideration in allograft selection for LCL/PLC.
  • Allograft reconstruction is a viable option for MCL and PLC injuries, offering functional knee recovery.