Minimally invasive reconstruction of the medial collateral ligament of the knee

Abstract

Objectives: This study describes a minimally invasive technique for the reconstruction of the medial collateral ligament (MCL) and posterior oblique ligament (POL) through minimal incisions on the tibial and femoral sides of the ligament using the modified Bosworth technique. Methods: This study included 19 consecutive patients who presented with chronic grade III injury; the mean age was 29.6 years (standard deviation ± 7.5 years, range 19–43 years), and five patients (26.3%) had no associated injuries. Ten patients (52.6%) had associated anterior cruciate ligament (ACL) injury and four patients (21.1%) had associated posterior cruciate ligament (PCL) injury. All patients were assessed 18 months postoperatively regarding functional outcome using the Lysholm score and medial joint space opening. Results: There was a statistically significant improvement in the patient functional outcome as the Lysholm score improved from 55.39 ± 6.9 to 89.42 ± 6.4 at 18 months postoperatively. (P-value < 0.001). At the end of the follow-up, 16 cases had grade 1 medial laxity, 3 cases with grade II laxity, and no patients with grade III medial laxity. Conclusion: Minimally invasive MCL reconstruction with modified Bosworth technique gives very good results regarding the knee s functional outcome and residual medial laxity. Keywords: medial collateral ligament, knee, reconstruction, posterior oblique ligament, minimally invasive techniques Level of evidence: Level IV