Singhi Prahalad Kumar, Rathod Pratik M, Elangovan Ajay Gowtham Amutham, Kumarasamy Gopi, Raju Sivakumar, Chidambaram M
Department of Orthopedics, Preethi Institute of Medical Sciences, Madurai, Tamil Nadu India.
Division of Arthroplasty and Trauma, Department of Orthopaedics, Preethi Institute of Medical Sciences, Madurai, Tamil Nadu India.
Indian J Orthop. 2025 Feb 27;59(4):501-511. doi: 10.1007/s43465-025-01351-3. eCollection 2025 Apr.
Medial collateral ligament is an important structure to stabilize the knee against valgus/rotatory forces and requires prompt treatment especially in MLKI scenario. The primary aim is to assess the outcome of our modified tunnel-less technique of MCL repair with hamstring augmentation/reconstruction using suture anchors and staples in MLKI.
This retrospective study included 26 patients of MLKI with concomitant valgus instability. All patients underwent MCL reconstruction or repair with augmentation.Patient demographic data, mode of injury, ligament injury pattern, surgical intervention, functional outcome and complications were compiled and evaluated. Outcomes including Lysholm score and ML-QOL score were computed at frequent intervals of 6, 12, and 18 months and final follow-up.
Of the 26 patients (21 males and 5 females), 9 patients underwent MCL repair with augmentation and 17 had MCL reconstruction. We had three cases of foot drop and one patient with vascular injury. The mean follow-up period of all the cases was 46.05 ± 10.04 months. Functional outcomes using Lysholm score improved significantly from 55.20 ± 6.42 at baseline to 90.79 ± 4.23 at final follow-up. Similar results were observed with the ML-QOL score which improved from 159.54 ± 14.65 to 61.04 ± 8.80 at final follow-up.
This novel tunnel-less technique of MCL augmentation/reconstruction proved to be effective in stabilizing the knee, with significant improvements in functional outcomes. Thus, it provides a feasible alternative for the management of MCL injury in MLKI, avoiding tunnel convergence and subsequent failures.
内侧副韧带是稳定膝关节以抵抗外翻/旋转力的重要结构，尤其在多韧带膝关节损伤（MLKI）的情况下需要及时治疗。主要目的是评估我们改良的无隧道技术用于在MLKI中使用缝线锚钉和吻合钉进行腘绳肌增强/重建内侧副韧带修复的效果。
这项回顾性研究纳入了26例伴有外翻不稳定的MLKI患者。所有患者均接受了内侧副韧带重建或增强修复。收集并评估患者的人口统计学数据、损伤方式、韧带损伤模式、手术干预、功能结果和并发症。在6个月、12个月和18个月的频繁间隔以及最终随访时计算包括Lysholm评分和ML-QOL评分在内的结果。
在26例患者（21例男性和5例女性）中，9例患者接受了增强内侧副韧带修复，17例进行了内侧副韧带重建。我们有3例足下垂和1例血管损伤患者。所有病例的平均随访期为46.05±10.04个月。使用Lysholm评分的功能结果从基线时的55.20±6.42显著改善至最终随访时的90.79±4.23。ML-QOL评分也有类似结果，从159.54±14.65改善至最终随访时的61.04±8.80。
这种新型的无隧道内侧副韧带增强/重建技术被证明在稳定膝关节方面是有效的，功能结果有显著改善。因此，它为MLKI中内侧副韧带损伤的治疗提供了一种可行的替代方法，避免了隧道汇聚及随后的失败。
