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Related Experiment Video

Updated: Jan 18, 2026

Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
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Simultaneous ACL Reconstruction and MCL Reconstruction in Patients with High BMI using Modified Lind Technique.

J B Vadhiraj Krishna1, Mohammed Aquib Shakeel1, A G Rakshith1

  • 1Department of Orthopaedics, St Johns Medical College and Hospital, Bengaluru, Karnataka, India.

Journal of Orthopaedic Case Reports
|September 12, 2025
PubMed
Summary

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This study shows that a modified Lind technique for simultaneous anterior cruciate ligament (ACL) and medial collateral ligament (MCL) reconstruction effectively restores knee stability and function. The procedure yielded excellent outcomes in patients with chronic ACL-MCL injuries.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Knee Biomechanics

Background:

  • Multiligamentous knee injuries (MLKI), particularly combined ACL and MCL tears, are complex and debilitating.
  • The medial collateral ligament (MCL) is frequently injured concurrently with the anterior cruciate ligament (ACL), especially in sports involving pivoting or hyperextension.
  • Various surgical techniques exist for MCL reconstruction, with modifications of the Lind technique showing promise.

Purpose of the Study:

  • To evaluate the efficacy of a modified Lind technique for simultaneous reconstruction of the superficial MCL (sMCL) and posterior oblique ligament (POL) in chronic ACL-MCL injuries.
  • To assess functional outcomes and knee stability following this surgical approach.

Main Methods:

  • A modified Lind technique involving semitendinosus rerouting with an intact tibial attachment and a 2-incision approach was used.
Keywords:
Anterior cruciate ligamentmedial collateral ligamentmultiligamentous knee injuryposterior oblique ligamentsuperficial medial collateral ligament

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  • Five patients with chronic ACL injuries and grade III valgus laxity underwent simultaneous ACL and MCL reconstruction.
  • Follow-up included Lysholm scoring and International Knee Documentation Committee (IKDC) subjective assessment.

    • Main Results:

    • All 5 patients achieved excellent results based on the Lysholm scoring system, with statistically significant improvement from pre-surgery to post-surgery (P < 0.001).
    • A significant improvement in IKDC subjective scores was observed at the 6-month follow-up.
    • The most common cause of injury was road traffic accidents (66%), followed by sports injuries (34%).

    Conclusions:

    • Simultaneous ACL-MCL reconstruction using the modified Lind technique provides good functional results and improves knee stability (anterior, valgus, and rotatory) in patients with chronic injuries.
    • This technique is effective for patients with a high body mass index (>25 kg/m2) and chronic ACL-MCL (grade III) injuries.