Funchal Luis F Z, Pasqualotto Eric, Ortiz Rafael, Astur Diego C, Cohen Moises
Hospital Baía Sul Medical Center, Florianópolis, Brazil.
Departamento de Medicina, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
Knee Surg Sports Traumatol Arthrosc. 2025 Jul 13. doi: 10.1002/ksa.12770.
This cohort study aimed to evaluate the outcomes of patients with combined anterior cruciate ligament (ACL) and grade II medial collateral ligament (MCL) injuries who exhibited the floating meniscus sign during arthroscopy and were treated with ACL and medial compartment reconstruction surgery.
Patients with combined ACL and grade II MCL injuries who underwent ACL and MCL reconstruction surgery between January 2019 and December 2022 were included in this study. The instability was classified as a grade II MCL injury, based on findings from magnetic resonance imaging and clinical examination. The Tegner activity scale and Lysholm score were collected preoperatively, 6, 12, 24, 36, 48 and 60 months postoperatively. Additionally, the number of patients with ACL reconstruction failure or residual MCL laxity at each follow-up time point was recorded.
A total of 197 patients underwent simultaneous reconstruction of the ACL and grade II MCL injuries. The mean age was 29 ± 9 years, and 83% were male. Six cases of ACL reconstruction failure were observed over 60 months, with no residual MCL valgus laxity at the final follow-up. Significant improvements in both the Tegner activity scale and Lysholm knee scoring scale were noted at all follow-up points compared to preoperative scores (p < 0.001).
The floating meniscus sign proved to be a valuable finding in guiding the surgical management of combined ACL and grade II MCL injuries. Our results suggest that, in physically active patients presenting with this sign, performing both ACL and MCL reconstruction leads to excellent mid-term outcomes, with significant functional improvement and a low rate of graft failure or residual valgus instability. This supports the surgical indication of MCL reconstruction in selected grade II injuries when the floating meniscus sign is present, potentially preventing long-term instability and suboptimal recovery.
Level III, retrospective cohort study.
本队列研究旨在评估在关节镜检查时出现半月板漂浮征，并接受前交叉韧带（ACL）和内侧间室重建手术治疗的前交叉韧带合并二级内侧副韧带（MCL）损伤患者的治疗结果。
纳入2019年1月至2022年12月期间接受ACL和MCL重建手术的ACL合并二级MCL损伤患者。根据磁共振成像和临床检查结果，将不稳定分类为二级MCL损伤。术前、术后6、12、24、36、48和60个月收集Tegner活动量表和Lysholm评分。此外，记录每个随访时间点ACL重建失败或残留MCL松弛的患者数量。
共有197例患者同时接受了ACL和二级MCL损伤的重建手术。平均年龄为29±9岁，83%为男性。在60个月内观察到6例ACL重建失败，末次随访时无残留MCL外翻松弛。与术前评分相比，所有随访点的Tegner活动量表和Lysholm膝关节评分量表均有显著改善（p<0.001）。
半月板漂浮征被证明是指导ACL合并二级MCL损伤手术治疗的有价值发现。我们的结果表明，对于出现此体征的体力活跃患者，同时进行ACL和MCL重建可带来良好的中期结果，功能显著改善，移植物失败或残留外翻不稳定率低。这支持了在存在半月板漂浮征的特定二级损伤中进行MCL重建的手术指征，可能预防长期不稳定和恢复不佳。
三级，回顾性队列研究。
