Tunnel-Less Medial Collateral Ligament Reconstruction in MLKI: A Novel Technique to Prevent Tunnel Convergence.

Abstract

Introduction: 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.

Materials and methods: 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.

Results: 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.

Conclusion: 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.