Allograft Use in Peripheral Knee Ligament Injuries (MCL and LCL): A Systematic Review.

Abstract

Comprehensive studies on the exclusive use of allografts for medial collateral ligament (MCL) and posterolateral corner (PLC) reconstruction are limited. This review assessed clinical and functional outcomes of allograft use for MCL and PLC reconstruction. The PRISMA guidelines were followed. A systematic search of the literature was performed in PubMed, MEDLINE, Web of Science, Cochrane (CENTRAL), and Scopus databases to identify published articles on clinical studies relevant to MCL and LCL reconstruction with the use of allografts. The results of the eligible studies were analyzed in terms of stability and functional outcomes, Lysholm score, objective and subjective International Knee Documentation Committee (IKDC) scores, Tegner activity scale, Cincinnati Knee Rating System, Marx score, complications, and graft failure. Nineteen studies with 547 patients undergoing LCL reconstructions using allografts were analyzed. The most common allograft used was the Achilles tendon. Mean lateral opening improved from 6.21 mm preoperatively to 1.88 mm postoperatively, with IKDC and Lysholm scores increasing significantly (44.02 to 74.78 and 53.44 to 85.68, respectively). The failure rate for LCL/PLC reconstructions was 11.13%, and complications occurred in 19.75%. For MCL reconstructions, 5 studies with 135 patients showed a reduction in medial opening from 9.7 mm to 2.33 mm, with increases in IKDC and Lysholm scores (49.8 to 75.92 and 69.3 to 85.46, respectively). The failure rate was 4.19%, with a 10.93% complication rate. The use of allografts for LCL and PLC reconstruction demonstrated satisfactory outcomes, with stable and functional knees, though there was a relatively high graft failure rate. Similarly, positive results were observed in MCL reconstruction with allografts. Level of Evidence: Level-IV.