Anatomic reconstruction of the medial collateral ligament in multi-ligaments knee injury using Achilles Allograft: a modification of Marx’s Technique

Keywords:

MCL repair ; Allograf t; Marx’s technique ; Superficial MCL ; Anchor sutures ; Staged reconstruction


Published online: Feb 09 2021

Hamidreza Yazdi, John Y. Kwon, Mohammad Ghorbanhoseini, Alireza Yousof Gomrokchi, Paniz Motaghi

From the Iran University of Medical Sciences

Abstract

Medial Collateral Ligament (MCL) injury may require operative treatment. Marx et al. described the latest technique for reconstruction of MCL. While good results have been reported using the Marx technique, some issues have been observed.

To address the mentioned issues, we have devised a modification to the Marx technique.

11 patients were enrolled and their ligaments were repaired according to this technique. At the last follow up the ROM, knee ligament laxity and functional outcome scores, subjective [IKDC] and Lysholm score were evaluated and recorded.

Knee motion was maintained in all cases. Two cases demonstrated 1+ valgus instability at 30 degree of knee flexion. Both were treated for combined MCL and PCL tear, the rest were stable. Average IKDC-subjective score was 93 ± 4 and average Lysholm score was 92 ± 3. All patients were satisfied and returned to their previous level of activity.

In this technique, the superficial MCL was reconstructed closer to its anatomical construct.

Patients didn’t have any complaints of hardware under skin and the need for second surgery for hardware removal was avoided. Also reconstructing the ligaments in 2 stages helped preserving the knee motion.

Level of Evidence: Level IV therapeutic.