{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:22:07Z","timestamp":1790554927167,"version":"4.1.0"},"reference-count":84,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T00:00:00Z","timestamp":1657152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T00:00:00Z","timestamp":1657152000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T00:00:00Z","timestamp":1657152000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T00:00:00Z","timestamp":1657152000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/100007307","name":"Arthrex","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007307","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007307","name":"Arthrex","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007307","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Combined injury of the anterior cruciate ligament (ACL) and medial collateral ligament (MCL) remains among the most common knee injury patterns in orthopaedics. Optimal treatment of grade III MCL injuries is still debated, especially when combined with ACL injury. Most patients with these severe injuries are treated conservatively for at least 6 weeks to allow for MCL healing, followed by delayed ACL reconstruction. Although acute treatment of the MCL was common in the 1970s, postoperative stiffness was frequently reported. Moreover, studies of such treatment failed to show clinical benefits of surgical over conservative treatment, and the MCL exhibited intrinsic healing capacity, leading to the consensus that all MCL injuries are treated conservatively. The current delayed treatment algorithm for ACL\u2010MCL injuries has several disadvantages. First, MCL healing may be incomplete, resulting in residual valgus laxity that places the ACL graft at greater risk of failure. Second, delayed treatment lengthens the overall rehabilitation period, thereby prolonging the presence of atrophy and delaying return to preinjury activity levels. Third, the initial healing period leaves the knee unstable for longer and risks further intra\u2010articular damage. Acute simultaneous surgical treatment of both ligaments has the potential to avoid these shortcomings. This article will review the evolution of treatment of ACL\u2010MCL injuries and explain how it shifted toward the current treatment algorithm. We will (1) discuss why the consensus shifted, (2) discuss the shortcomings of the current treatment plan, (3) discuss the potential advantages of acute simultaneous treatment, and (4) present an overview of the available literature.<\/jats:p>","DOI":"10.1016\/j.arthro.2022.06.023","type":"journal-article","created":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T07:27:17Z","timestamp":1657265237000},"page":"1099-1107","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":31,"title":["Treating Combined Anterior Cruciate Ligament and Medial Collateral Ligament Injuries Operatively in the Acute Setting Is Potentially Advantageous"],"prefix":"10.1002","volume":"39","author":[{"given":"Kurt","family":"Holuba","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harmen D.","family":"Vermeijden","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery New York New York U.S.A."},{"name":"Department of Orthopaedic Surgery Amsterdam UMC Location University of Amsterdam Amsterdam the Netherlands"},{"name":"Amsterdam Movement Sciences\u2013Sports Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuyi A.","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelle P.","family":"van der List","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery New York New York U.S.A."},{"name":"Department of Orthopaedic Surgery Amsterdam UMC Location University of Amsterdam Amsterdam the Netherlands"},{"name":"Amsterdam Movement Sciences\u2013Sports Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory S.","family":"DiFelice","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,7]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-016-2497-6"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354659502300208"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/BLO.0b013e31802b4a86"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197805000-00038"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354658301100602"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199072030-00010"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354658100900605"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354658301100511"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198003000-00005"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198365030-00005"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197456060-00009"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100140209"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100090407"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00395795"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546505284889"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1248204"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199602000-00002"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354659202000308"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0000000000000063"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.10.138"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2016.09.006"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671211050929"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.1.000007"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.08.293"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2016.08.005"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-019-09549-3"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001670000126"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199204000-00027"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354659202000503"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199103000-00031"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354659202000103"},{"key":"e_1_2_6_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198301000-00042"},{"key":"e_1_2_6_34_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198602000-00038"},{"key":"e_1_2_6_35_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100100619"},{"key":"e_1_2_6_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0736-0266(03)00051-2"},{"key":"e_1_2_6_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199312000-00042"},{"key":"e_1_2_6_38_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199204000-00034"},{"key":"e_1_2_6_39_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-008-0689-6"},{"key":"e_1_2_6_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-006-0039-4"},{"key":"e_1_2_6_41_2","doi-asserted-by":"publisher","DOI":"10.7863\/jum.1996.15.9.621"},{"key":"e_1_2_6_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2014.12.010"},{"key":"e_1_2_6_43_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354659502300402"},{"key":"e_1_2_6_44_2","doi-asserted-by":"publisher","DOI":"10.3928\/0147-7447-20040401-15"},{"key":"e_1_2_6_45_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1688689"},{"key":"e_1_2_6_46_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453679508995587"},{"key":"e_1_2_6_47_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1599203"},{"key":"e_1_2_6_48_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465030310021801"},{"key":"e_1_2_6_49_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0000000000000066"},{"key":"e_1_2_6_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2014.08.019"},{"key":"e_1_2_6_51_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.44B4.869"},{"key":"e_1_2_6_52_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-009-0992-6"},{"key":"e_1_2_6_53_2","first-page":"255","article-title":"Anatomical repair of Stener\u2010like lesion of medial collateral ligament: A case series and technical note","volume":"5","author":"Keyhani S.","year":"2017","journal-title":"Arch Bone Jt Surg"},{"key":"e_1_2_6_54_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100090106"},{"key":"e_1_2_6_55_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199704000-00031"},{"key":"e_1_2_6_56_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453679308993699"},{"key":"e_1_2_6_57_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2017.03.003"},{"key":"e_1_2_6_58_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120981875"},{"key":"e_1_2_6_59_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05668-z"},{"key":"e_1_2_6_60_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517751916"},{"key":"e_1_2_6_61_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20160427-13"},{"key":"e_1_2_6_62_2","doi-asserted-by":"publisher","DOI":"10.1016\/0020-1383(83)90034-7"},{"key":"e_1_2_6_63_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197311000-00019"},{"key":"e_1_2_6_64_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.01571"},{"key":"e_1_2_6_65_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01845588"},{"key":"e_1_2_6_66_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.10.114"},{"key":"e_1_2_6_67_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354658701500103"},{"key":"e_1_2_6_68_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06084-4"},{"key":"e_1_2_6_69_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0736-0266(03)00080-9"},{"key":"e_1_2_6_70_2","doi-asserted-by":"publisher","DOI":"10.1007\/s007760070007"},{"key":"e_1_2_6_71_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001670050128"},{"key":"e_1_2_6_72_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199173020-00013"},{"key":"e_1_2_6_73_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516685312"},{"key":"e_1_2_6_74_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4575-x"},{"key":"e_1_2_6_75_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508324969"},{"key":"e_1_2_6_76_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-5237-3"},{"key":"e_1_2_6_77_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513493594"},{"key":"e_1_2_6_78_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.1998.27.6.407"},{"key":"e_1_2_6_79_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2008.057059"},{"key":"e_1_2_6_80_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2013.07.273"},{"key":"e_1_2_6_81_2","first-page":"119258","article-title":"Combined injuries of the medial collateral ligament and the anterior cruciate ligament. Early ACL reconstruction versus late ACL reconstruction","author":"Petersen W.","year":"1999","journal-title":"Arch Orthop Trauma Surg."},{"key":"e_1_2_6_82_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-5012-5"},{"key":"e_1_2_6_83_2","article-title":"Early and delayed surgery for isolated ACL and multiligamentous knee injuries have equivalent results: A systematic review and meta\u2010analysis","volume":"363546521106935","author":"Vermeijden HD","year":"2022","journal-title":"Am J Sports Med"},{"key":"e_1_2_6_84_2","doi-asserted-by":"crossref","unstructured":"Sim JA Na YG Choi JW Lee BH. Early medial reconstruction combined with severely injured medial collateral ligaments can decrease residual medial laxity in anterior cruciate ligament reconstruction.Arch Orthop Trauma Surg2021. doi:10.1007\/s00402\u2010021\u201004211\u20105.","DOI":"10.1007\/s00402-021-04211-5"},{"key":"e_1_2_6_85_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354659302100104"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S074980632200398X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S074980632200398X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2022.06.023","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2022.06.023","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2022.06.023","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T08:57:05Z","timestamp":1773565025000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2022.06.023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,7]]},"references-count":84,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1016\/j.arthro.2022.06.023"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2022.06.023","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Treating Combined Anterior Cruciate Ligament and Medial Collateral Ligament Injuries Operatively in the Acute Setting Is Potentially Advantageous","name":"articletitle","label":"Article Title"},{"value":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arthro.2022.06.023","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 Published by Elsevier on behalf of the Arthroscopy Association of North America","name":"copyright","label":"Copyright"}]}}