ACL Graft Type Effects on Outcomes Were Not Significantly Modified by Medial Collateral Ligament Status in Combined ACL-MCL Injuries: A Multicenter Registry Study From the French Arthroscopic Society

This French multicenter registry study of 489 analyzable patients undergoing primary ACL reconstruction asked whether a concomitant MCL injury (absent, treated nonoperatively, or treated operatively) changes how hamstring versus nonhamstring grafts relate to patient-reported outcomes. After propensity-score weighting, nonhamstring grafts were associated with about 8 points higher IKDC scores overall (beta 7.89, 95% CI 3.45 to 12.33). The graft-by-MCL interaction was not statistically significant (operative MCL interaction beta about -7.0, 95% CI about -15.3 to 1.2, P = .095), so there was no clear evidence that MCL status changed the graft effect.

AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing

Why it mattersGraft choice in combined ACL-MCL injuries is a common board and clinic question, and this study suggests the theoretical worry about hamstring harvest weakening medial dynamic restraint is not clearly borne out in short-term patient-reported outcomes.

Presenting this at rounds? Start here

• ?When counseling a pivoting athlete with a combined ACL-MCL injury, how much weight should the theoretical loss of hamstring dynamic valgus restraint carry when choosing between a hamstring and a patellar or quadriceps tendon autograft?
• ?Should a patient with a combined ACL-MCL injury managed nonoperatively be counseled to expect lower subjective knee function than one with an isolated ACL tear, and how might that change rehabilitation and follow-up?