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To facilitate ease of access, partial lengthening of the medial collateral ligament (MCL) \u201cpie\u2010crusting\u201d has been advocated to increase the working space of the medial compartment during arthroscopy. Purported benefits of MCL include increased visualization and decreased misdiagnosis during diagnostic arthroscopy, decreased iatrogenic chondral injuries with instrumentation, and postoperative medial compartment off\u2010loading. Several techniques of MCL lengthening have been described including percutaneous lengthening, transportal lengthening, and mini\u2010open lengthening. The safety of MCL lengthening has been demonstrated. Patients receiving MCL lengthening have no difference in postoperative laxity, postoperative pain, nor damage to surrounding structures. MCL lengthening also shows improved patient outcome scores and decreased rates of retear of medial meniscal root tear repair.<\/jats:p>","DOI":"10.1016\/j.arthro.2023.08.066","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T10:49:43Z","timestamp":1705056583000},"page":"876-878","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"title":["<i>Editorial Commentary:<\/i>\n                    Pie\u2010Crusting for Medial Meniscal Root Repair Shows Improved Outcomes Without Laxity"],"prefix":"10.1002","volume":"40","author":[{"given":"David","family":"Woodard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven F.","family":"DeFroda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,11]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2023.07.029"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2022.04.004"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00113-004-0841-8"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2012.10.008"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2021.07.041"},{"key":"e_1_2_2_7_2","article-title":"Which fibers of the medial collateral ligament (MCL) should be released in the pie crust technique applied during knee arthroscopy: Superficial MCL or deep MCL?","volume":"13","author":"Ar\u0131can G.","year":"2021","journal-title":"Cureus"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2019.11.008"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1668125"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2019.08.051"},{"key":"e_1_2_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2015.07.013"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806323007338?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806323007338?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.2023.08.066","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2023.08.066","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2023.08.066","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T08:47:50Z","timestamp":1773564470000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2023.08.066"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,11]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1016\/j.arthro.2023.08.066"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2023.08.066","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Editorial Commentary: Pie-Crusting for Medial Meniscal Root Repair Shows Improved Outcomes Without Laxity","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.2023.08.066","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"https:\/\/doi.org\/10.1016\/j.arthro.2023.07.029","name":"associatedlink","label":"CrossRef DOI link to the associated document"},{"value":"simple-article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 by the Arthroscopy Association of North America","name":"copyright","label":"Copyright"}]}}