2021 ISAKOS Biennial Congress ePoster
Comparison Of Outcomes For Medial Collateral Ligament Repair Versus Reconstruction: A Systematic Review
Edward Floyd, MD, MS, Fargo, ND UNITED STATES
Kari L. Falaas, BS, Minneapolis, Minnesota UNITED STATES
Nicholas J. Ebert, BS, Minneapolis, Minnesota UNITED STATES
Griffin D. Struyk, BS, Minneapolis, Minnesota UNITED STATES
Gregory B Carlson, MD, St. Louis Park, MN UNITED STATES
Robert F. LaPrade, MD, PhD, Edina, MN UNITED STATES
Twin Cities Orthopedics, Minneapolis, Minnesota, UNITED STATES
FDA Status Cleared
Summary
An investigation of the literature to compare subjective and objective outcomes for surgical repair versus reconstruction of the medial collateral ligament (MCL)/Posteromedial complex (PMC).
ePosters will be available shortly before Congress
Abstract
Background
A paucity of data exists to guide surgical management of the medial collateral ligament (MCL)/posteromedial complex (PMC). High-grade PMC injuries are often treated with surgical repair or reconstruction; however, guidelines for choosing one or the other technique remain unclear.
Purpose
To systematically review the literature to determine whether repair or reconstruction of the MCL results in better outcomes.
Methods
Using the PRISMA checklist, a systematic review of the literature retrieved results from MEDLINE, Embase, Cochrane, and PubMed databases from 01/1980-01/2021. Exclusion criteria were age <15, technical/case reports, articular fractures, non-operative treatment, and undifferentiated multiligament results.
Results
The authors found five studies which included both MCL repair and reconstruction results (Group A: 109 repairs, 126 reconstructions). The mean patient age was 31.4 years, and mean follow-up time was 4.02 years (minimum, 2 years). Post-operative Lysholm score means for repair and reconstruction were 88.6 and 82.4, respectively. Two studies reported IKDC subjective scores; the means for repair and reconstruction were 68.3 and 42.3, respectively. There was no statistically significant difference found between reconstruction and repair groups of the MCL for Lysholm, Tegner, KOOS, stress radiographs, subjective or objective IKDC scores, and cases of failures (p>.05). No significant difference of arthrofibrosis rates (p>.05) or failure rates (p>.05) were found between repair and reconstruction groups. Across a broader pool of 32 studies (Group B), including studies which provided MCL repair and reconstruction results, and studies which only included results of MCL repair or reconstruction, post-operative arthrofibrosis was noted in 54 of 498 MCL repairs (10.8%) and 31 of 490 (6.3%) MCL/PMC reconstructions. Arthrofibrosis rates were significantly lower in the reconstruction group vs the repair group ((?2=6.4575, p value= 0.01105).
Conclusion
Post-operative arthrofibrosis appears to be more common after MCL repair than MCL/PMC reconstruction. Improved data would be gained by publication of more results detailing MCL repair and MCL/PMC reconstruction side-by-side.