title: Does ACL reconstruction restore knee stability in combined lesions?: An in vivo study.
abstract: Treating anterior cruciate ligament (ACL) lesions combined with a torn medial collateral ligament (MCL) is controversial because residual laxity may lead to stretching of the ACL graft and eventual failure of the reconstruction. Few studies describe the in vivo translations of combined ACL and MCL injuries. We compared the preoperative and postoperative laxity between patients with combined ACL+MCL Grade II injuries and isolated ACL ruptures and tested whether an ACL reconstruction could restore all laxities in both groups. We evaluated knee kinematics during ACL reconstruction in 57 patients (37 ACL lesions and 20 ACL+MCL injury). Laxity tests were performed before and after graft fixation. Postoperatively, there was greater anteroposterior laxity and greater varus-valgus laxity in the group with MCL injury compared to the group with an ACL lesion only. This finding suggests residual laxities remain when ACL reconstruction is performed in patients with combined ACL+MCL lesion, and raises the question of addressing the MCL ligament when Grade II laxity is found.
authors.affiliation: Laboratorio di Biomeccanica, Istituti Ortopedici Rizzoli, Bologna, Italy. s.zaffagnini@biomec.ior.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Zaffagnini
authors.forename: Simone
authors.initials: S
authors.lastname: Bignozzi
authors.forename: Sandra
authors.initials: S
authors.lastname: Martelli
authors.forename: Nicola
authors.initials: N
authors.lastname: Lopomo
authors.forename: Maurilio
authors.initials: M
authors.lastname: Marcacci
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001696:Biomechanical Phenomena / Q000379:methods; D016022:Case-Control Studies; D017885:Collateral Ligaments / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D017888:Medial Collateral Ligament, Knee / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D012421:Rupture; D016896:Treatment Outcome