Short- to mid-term outcomes of anatomic MCL reconstruction with Achilles tendon allograft after multiligament knee injury

Ian J. Barrett, Aaron Krych, Ayoosh Pareek, Nicholas R. Johnson, Diane L. Dahm, Michael J. Stuart, Bruce A Levy

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: Multiple techniques have been described in the literature for reconstruction of the medial collateral ligament. The purpose of this study is to describe functional outcome, range of motion, and knee stability following anatomic MCL reconstruction utilizing an Achilles tendon bone allograft after multiligament knee injury. Methods: A comprehensive search of a single-hospital multiligament knee injury (MLKI) procedural database was conducted to identify all patients that underwent reconstruction of the MCL utilizing an Achilles tendon bone allograft and with 2-year clinical follow-up. Medical charts were retrospectively reviewed to determine each patient’s knee dislocation (KD) grade, final range of motion, stability on clinical examination, and the incidence of complications and reoperations. KOOS, IKDC, and Marx scores were also collected. Results: Thirty-two knees in 32 patients (21 males and 11 females) with a mean age of 30 years (range 15–51) were followed for an average of 40 months (range 28–87 months) following MCL reconstruction with Achilles tendon bone allograft. For patients with multiligament knee injuries, there were 14 KD-I (11 ACL/MCL; 3 MCL/PCL; 1 MCL/ACL/LCL; 1 MCL/PCL/LCL), 12 KD 3-M, and 3 KD-IV. One patient underwent isolated revision MCL reconstruction. At final follow-up, clinically significant valgus laxity was observed in only 1 patient (3%). All patients were able to achieve full extension of the knee and the average flexion was 121.1 ± 19.6. The average IKDC score was 67.6 ± 19.9 (range 27.7–98.9), the average KOOS score 77.1 ± 16.8 (range 31–100). The average Marx score was 4.9 (range 0–16, SD 5.2). Thirty-one of 32 (96%) patients reported being satisfied with results of the surgery. Knee dislocation grades were significantly correlated with post-operative outcome measures. Conclusion: In a series utilizing a modified Marx Achilles tendon, MCL reconstruction in the setting of MLKI demonstrated satisfactory clinical and functional outcomes, as well as patient satisfaction at short- to mid-term follow-up. Furthermore, knee dislocation grades were demonstrated to correlate with post-operative IKDC, KOOS, and Marx scores. Level of evidence: Type IV.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalKnee Surgery, Sports Traumatology, Arthroscopy
DOIs
StateAccepted/In press - Feb 9 2018

Fingerprint

Knee Injuries
Achilles Tendon
Knee Dislocation
Allografts
Knee
Articular Range of Motion
Bone and Bones
Collateral Ligaments
Patient Satisfaction
Reoperation
Outcome Assessment (Health Care)
Databases
Incidence

Keywords

  • Achilles tendon allograft
  • Ligament reconstruction
  • MCL reconstruction
  • Medial collateral ligament
  • Reconstruction

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Short- to mid-term outcomes of anatomic MCL reconstruction with Achilles tendon allograft after multiligament knee injury. / Barrett, Ian J.; Krych, Aaron; Pareek, Ayoosh; Johnson, Nicholas R.; Dahm, Diane L.; Stuart, Michael J.; Levy, Bruce A.

In: Knee Surgery, Sports Traumatology, Arthroscopy, 09.02.2018, p. 1-8.

Research output: Contribution to journalArticle

@article{525123daa2364fde956372678bb731d8,
title = "Short- to mid-term outcomes of anatomic MCL reconstruction with Achilles tendon allograft after multiligament knee injury",
abstract = "Purpose: Multiple techniques have been described in the literature for reconstruction of the medial collateral ligament. The purpose of this study is to describe functional outcome, range of motion, and knee stability following anatomic MCL reconstruction utilizing an Achilles tendon bone allograft after multiligament knee injury. Methods: A comprehensive search of a single-hospital multiligament knee injury (MLKI) procedural database was conducted to identify all patients that underwent reconstruction of the MCL utilizing an Achilles tendon bone allograft and with 2-year clinical follow-up. Medical charts were retrospectively reviewed to determine each patient’s knee dislocation (KD) grade, final range of motion, stability on clinical examination, and the incidence of complications and reoperations. KOOS, IKDC, and Marx scores were also collected. Results: Thirty-two knees in 32 patients (21 males and 11 females) with a mean age of 30 years (range 15–51) were followed for an average of 40 months (range 28–87 months) following MCL reconstruction with Achilles tendon bone allograft. For patients with multiligament knee injuries, there were 14 KD-I (11 ACL/MCL; 3 MCL/PCL; 1 MCL/ACL/LCL; 1 MCL/PCL/LCL), 12 KD 3-M, and 3 KD-IV. One patient underwent isolated revision MCL reconstruction. At final follow-up, clinically significant valgus laxity was observed in only 1 patient (3{\%}). All patients were able to achieve full extension of the knee and the average flexion was 121.1 ± 19.6. The average IKDC score was 67.6 ± 19.9 (range 27.7–98.9), the average KOOS score 77.1 ± 16.8 (range 31–100). The average Marx score was 4.9 (range 0–16, SD 5.2). Thirty-one of 32 (96{\%}) patients reported being satisfied with results of the surgery. Knee dislocation grades were significantly correlated with post-operative outcome measures. Conclusion: In a series utilizing a modified Marx Achilles tendon, MCL reconstruction in the setting of MLKI demonstrated satisfactory clinical and functional outcomes, as well as patient satisfaction at short- to mid-term follow-up. Furthermore, knee dislocation grades were demonstrated to correlate with post-operative IKDC, KOOS, and Marx scores. Level of evidence: Type IV.",
keywords = "Achilles tendon allograft, Ligament reconstruction, MCL reconstruction, Medial collateral ligament, Reconstruction",
author = "Barrett, {Ian J.} and Aaron Krych and Ayoosh Pareek and Johnson, {Nicholas R.} and Dahm, {Diane L.} and Stuart, {Michael J.} and Levy, {Bruce A}",
year = "2018",
month = "2",
day = "9",
doi = "10.1007/s00167-018-4843-4",
language = "English (US)",
pages = "1--8",
journal = "Knee Surgery, Sports Traumatology, Arthroscopy",
issn = "0942-2056",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Short- to mid-term outcomes of anatomic MCL reconstruction with Achilles tendon allograft after multiligament knee injury

AU - Barrett, Ian J.

AU - Krych, Aaron

AU - Pareek, Ayoosh

AU - Johnson, Nicholas R.

AU - Dahm, Diane L.

AU - Stuart, Michael J.

AU - Levy, Bruce A

PY - 2018/2/9

Y1 - 2018/2/9

N2 - Purpose: Multiple techniques have been described in the literature for reconstruction of the medial collateral ligament. The purpose of this study is to describe functional outcome, range of motion, and knee stability following anatomic MCL reconstruction utilizing an Achilles tendon bone allograft after multiligament knee injury. Methods: A comprehensive search of a single-hospital multiligament knee injury (MLKI) procedural database was conducted to identify all patients that underwent reconstruction of the MCL utilizing an Achilles tendon bone allograft and with 2-year clinical follow-up. Medical charts were retrospectively reviewed to determine each patient’s knee dislocation (KD) grade, final range of motion, stability on clinical examination, and the incidence of complications and reoperations. KOOS, IKDC, and Marx scores were also collected. Results: Thirty-two knees in 32 patients (21 males and 11 females) with a mean age of 30 years (range 15–51) were followed for an average of 40 months (range 28–87 months) following MCL reconstruction with Achilles tendon bone allograft. For patients with multiligament knee injuries, there were 14 KD-I (11 ACL/MCL; 3 MCL/PCL; 1 MCL/ACL/LCL; 1 MCL/PCL/LCL), 12 KD 3-M, and 3 KD-IV. One patient underwent isolated revision MCL reconstruction. At final follow-up, clinically significant valgus laxity was observed in only 1 patient (3%). All patients were able to achieve full extension of the knee and the average flexion was 121.1 ± 19.6. The average IKDC score was 67.6 ± 19.9 (range 27.7–98.9), the average KOOS score 77.1 ± 16.8 (range 31–100). The average Marx score was 4.9 (range 0–16, SD 5.2). Thirty-one of 32 (96%) patients reported being satisfied with results of the surgery. Knee dislocation grades were significantly correlated with post-operative outcome measures. Conclusion: In a series utilizing a modified Marx Achilles tendon, MCL reconstruction in the setting of MLKI demonstrated satisfactory clinical and functional outcomes, as well as patient satisfaction at short- to mid-term follow-up. Furthermore, knee dislocation grades were demonstrated to correlate with post-operative IKDC, KOOS, and Marx scores. Level of evidence: Type IV.

AB - Purpose: Multiple techniques have been described in the literature for reconstruction of the medial collateral ligament. The purpose of this study is to describe functional outcome, range of motion, and knee stability following anatomic MCL reconstruction utilizing an Achilles tendon bone allograft after multiligament knee injury. Methods: A comprehensive search of a single-hospital multiligament knee injury (MLKI) procedural database was conducted to identify all patients that underwent reconstruction of the MCL utilizing an Achilles tendon bone allograft and with 2-year clinical follow-up. Medical charts were retrospectively reviewed to determine each patient’s knee dislocation (KD) grade, final range of motion, stability on clinical examination, and the incidence of complications and reoperations. KOOS, IKDC, and Marx scores were also collected. Results: Thirty-two knees in 32 patients (21 males and 11 females) with a mean age of 30 years (range 15–51) were followed for an average of 40 months (range 28–87 months) following MCL reconstruction with Achilles tendon bone allograft. For patients with multiligament knee injuries, there were 14 KD-I (11 ACL/MCL; 3 MCL/PCL; 1 MCL/ACL/LCL; 1 MCL/PCL/LCL), 12 KD 3-M, and 3 KD-IV. One patient underwent isolated revision MCL reconstruction. At final follow-up, clinically significant valgus laxity was observed in only 1 patient (3%). All patients were able to achieve full extension of the knee and the average flexion was 121.1 ± 19.6. The average IKDC score was 67.6 ± 19.9 (range 27.7–98.9), the average KOOS score 77.1 ± 16.8 (range 31–100). The average Marx score was 4.9 (range 0–16, SD 5.2). Thirty-one of 32 (96%) patients reported being satisfied with results of the surgery. Knee dislocation grades were significantly correlated with post-operative outcome measures. Conclusion: In a series utilizing a modified Marx Achilles tendon, MCL reconstruction in the setting of MLKI demonstrated satisfactory clinical and functional outcomes, as well as patient satisfaction at short- to mid-term follow-up. Furthermore, knee dislocation grades were demonstrated to correlate with post-operative IKDC, KOOS, and Marx scores. Level of evidence: Type IV.

KW - Achilles tendon allograft

KW - Ligament reconstruction

KW - MCL reconstruction

KW - Medial collateral ligament

KW - Reconstruction

UR - http://www.scopus.com/inward/record.url?scp=85041804214&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85041804214&partnerID=8YFLogxK

U2 - 10.1007/s00167-018-4843-4

DO - 10.1007/s00167-018-4843-4

M3 - Article

C2 - 29427218

AN - SCOPUS:85041804214

SP - 1

EP - 8

JO - Knee Surgery, Sports Traumatology, Arthroscopy

JF - Knee Surgery, Sports Traumatology, Arthroscopy

SN - 0942-2056

ER -