Impact of preoperative measures on postoperative results in combined anterior cruciate and medial collateral ligament injuries: an analysis from the registry of the francophone arthroscopic society

IF 2.2 3区医学 Q2 ORTHOPEDICS

Orthopaedics & Traumatology-Surgery & Research Pub Date : 2025-10-01 DOI:10.1016/j.otsr.2025.104185

Benjamin Freychet , Nicolas Bouguennec , Emilie Berard , Alexandre Hardy , Corentin Herce , Charles Kajetanek , Christian Lutz , Thomas Neri , Matthieu Ollivier , Etienne Cavaignac

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Abstract

Background

Combined injuries of the anterior cruciate ligament (ACL) and medial collateral ligament (MCL) are frequent in knee trauma. Treatment approaches vary widely, including surgical and conservative methods. However, the impact of preoperative measures on postoperative outcomes remains unclear.

Hypothesis

Preoperative measures influence on postoperative outcomes for cases involving combined anterior cruciate and medial collateral ligament injuries.

Patients and methods

A prospective, multicenter study was conducted in 8 French surgical centers specializing in knee surgery. Data were collected on patients undergoing ACL reconstruction with concomitant MCL injury over a 12-month period. Inclusion criteria were primary ACL injury associated with MCL injury (Grade I, II or III) and requiring ACL reconstruction, patients aged ≥ 15 years. The use and type of preoperative brace, weight-bearing and the time between injury and surgery were assessed. A functional assessment of the IKDC, ACL-RSI, TEGNER and SKV scores was performed at final follow-up. Patients were evaluated with regards of iterative ACL rupture, contralateral ACL rupture and reoperation.

Results

The study included 408 patients with a mean follow-up of 18.5 months. Time between injury and surgery did not significantly affect the risk of iterative rupture, contralateral rupture, or reoperation. No significant impact of preoperative brace type or weight-bearing status on postoperative outcomes was observed. However, patients with higher grade MCL injuries underwent surgery earlier (p < 0.0001) and had lower preoperative weight-bearing allowances (p < 0.05). Patients with Grade 2−3 MCL injuries had lower functional scores compared to those with Grade 1 injuries (p < 0.05).

Discussion

Preoperative measures, including time between injury and surgery, showed no significant influence on postoperative outcomes in combined ACL-MCL injuries. The type of preoperative brace and weight-bearing status did not significantly impact postoperative results. A functional approach with immediate full weight-bearing/recovery of full range of motion and with the use of bracing according to pain and patient apprehension is recommended. Further research is needed to refine preoperative treatment strategies for such injuries.

Level of evidence

IV; prospective study.

查看原文本刊更多论文

前交叉韧带和内侧副韧带合并损伤的术前措施对术后结果的影响：来自法语关节镜学会注册表的分析。

背景：前交叉韧带（ACL）和内侧副韧带（MCL）的联合损伤是膝关节外伤中常见的损伤。治疗方法多种多样，包括手术和保守方法。然而，术前措施对术后结果的影响尚不清楚。假设：术前措施影响合并前交叉韧带和内侧副韧带损伤病例的术后预后。患者和方法：在法国8个专门从事膝关节手术的外科中心进行了一项前瞻性、多中心研究。在12个月的时间里，收集了接受ACL重建并伴有MCL损伤的患者的数据。纳入标准为原发性ACL损伤合并MCL损伤（I级、II级或III级），需要ACL重建，患者年龄≥15岁。评估术前支具的使用和类型、负重情况以及损伤与手术之间的时间。在最后随访时进行IKDC、ACL-RSI、TEGNER和SKV评分的功能评估。对患者进行反复前交叉韧带破裂、对侧前交叉韧带破裂和再手术的评估。结果：共纳入408例患者，平均随访18.5个月。损伤和手术之间的时间对反复破裂、对侧破裂或再手术的风险没有显著影响。术前支架类型和负重状态对术后结果无明显影响。讨论：术前措施，包括损伤和手术之间的时间，显示对ACL-MCL联合损伤的术后结局没有显著影响。术前支具类型和负重状态对术后结果无显著影响。建议采用功能性入路，立即完全负重/恢复全活动范围，并根据疼痛和患者的理解使用支具。需要进一步的研究来完善此类损伤的术前治疗策略。证据等级：四级；前瞻性研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Orthopaedics & Traumatology-Surgery & Research 医学-外科

CiteScore

5.10

自引率

26.10%

发文量

329

审稿时长

12.5 weeks

期刊介绍： Orthopaedics & Traumatology: Surgery & Research (OTSR) publishes original scientific work in English related to all domains of orthopaedics. Original articles, Reviews, Technical notes and Concise follow-up of a former OTSR study are published in English in electronic form only and indexed in the main international databases.