{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T14:39:23Z","timestamp":1768315163701,"version":"3.49.0"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Purpose<\/jats:title>\n \n Combined anterior cruciate ligament (\n ACL<\/jats:styled-content>\n ) and medial collateral ligament (\n MCL<\/jats:styled-content>\n ) injuries are common and present challenges in management. While\n ACL<\/jats:styled-content>\n reconstruction has been established, the optimal approach for combined\n ACL<\/jats:styled-content>\n and\n MCL<\/jats:styled-content>\n injuries remains debatable owing to the varying severity and chronicity of\n MCL<\/jats:styled-content>\n injuries. This study aimed to describe a novel surgical technique for chronic\n ACL<\/jats:styled-content>\n and grade\n III MCL<\/jats:styled-content>\n injuries and assess whether simultaneous\n ACL<\/jats:styled-content>\n and\n MCL<\/jats:styled-content>\n reconstruction improves chronic\n MCL<\/jats:styled-content>\n instability.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A total of 41 patients diagnosed with combined ACL and MCL injuries were included in the study. Twenty\u2010five patients were allocated into the simple ACL reconstruction (SAR) group while 16 patients were allocated into the simultaneous ACL and MCL reconstruction (SAMR) group according to MCL injury severity. The surgical technique utilized a single ipsilateral hamstring autograft for both ACL and MCL reconstruction. Clinical assessments, including range of motion (ROM), functional score, Lachman test, and valgus instability, were conducted before and after surgery. Postoperative magnetic resonance imaging (MRI) was used to evaluate graft quality.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Postoperative outcomes revealed significant improvements in\n ROM<\/jats:styled-content>\n , functional scores, Lachman test, and valgus instability in both groups. There were no significant differences between the\n SAR<\/jats:styled-content>\n and\n SAMR<\/jats:styled-content>\n groups, suggesting that patients with combined\n ACL<\/jats:styled-content>\n rupture and severe\n MCL<\/jats:styled-content>\n injuries can achieve similar stability outcomes as those with\n ACL<\/jats:styled-content>\n rupture and mild\n MCL<\/jats:styled-content>\n injuries. The\n MRI<\/jats:styled-content>\n results revealed high\u2010quality grafts in both groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n This study introduces a novel technique using simple hamstring autografts for simultaneous\n ACL<\/jats:styled-content>\n and\n MCL<\/jats:styled-content>\n reconstruction, and this surgical technique can achieve knee stability comparable to that of low\u2010grade\n MCL<\/jats:styled-content>\n injuries and can be used for single\n ACL<\/jats:styled-content>\n reconstruction. Further research with larger sample sizes and long\u2010term follow\u2010up is needed to confirm these findings.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/os.70234","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T09:34:31Z","timestamp":1766741671000},"page":"126-137","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Delayed Simultaneous Reconstruction of the\n ACL<\/scp>\n and\n MCL<\/scp>\n Using Ipsilateral Single Hamstring Tendon Autograft With A Modified Technique"],"prefix":"10.1111","volume":"18","author":[{"given":"Cheng\u2010Yi","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Orthopedics Shin Kong Wu Ho\u2010Su Memorial Hospital Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9167-7871","authenticated-orcid":false,"given":"Po\u2010Jen","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Shuang Ho Hospital, Taipei Medical University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming\u2010Ta","family":"Yang","sequence":"additional","affiliation":[{"name":"Center for General Education Taipei Medical University Taipei Taiwan"},{"name":"Clinical Research Center Taipei Medical University Hospital Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1593-4573","authenticated-orcid":false,"given":"Er\u2010Yuan","family":"Chuang","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering Taipei Medical University Taipei Taiwan"},{"name":"International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering Taipei Medical University Taipei Taiwan"},{"name":"Cell Physiology and Molecular Image Research Center Taipei Medical University\u2010Wan Fang Hospital Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4906-2136","authenticated-orcid":false,"given":"Wen\u2010Pei","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Nursing Shuang Ho Hospital, Taipei Medical University New Taipei City Taiwan"},{"name":"School of Nursing, College of Nursing Taipei Medical University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tan Cheng","family":"Aun","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Lam Wah Ee Hospital Penang Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei\u2010Wei","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Shuang Ho Hospital, Taipei Medical University Taipei Taiwan"},{"name":"Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering Taipei Medical University Taipei Taiwan"},{"name":"Research Center of Biomedical Device Taipei Medical University Taipei Taiwan"},{"name":"Department of Orthopaedics, School of Medicine, College of Medicine Taipei Medical University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2017.03.003"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-016-2497-6"},{"key":"e_1_2_13_4_1","first-page":"77","article-title":"MCL Injuries of the Knee: Current Concepts Review","volume":"26","author":"Phisitkul P.","year":"2006","journal-title":"Iowa Orthopaedic Journal"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-019-09549-3"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2022.07.024"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514531394"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.10.138"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.08.293"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516685312"},{"issue":"2","key":"e_1_2_13_11_1","first-page":"159","article-title":"Classification of Knee Ligament Instabilities. Part I. The Medial Compartment and Cruciate Ligaments","volume":"58","author":"Hughston J. C.","year":"1976","journal-title":"Journal of Bone and Joint Surgery. American Volume"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510385999"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546505284889"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465231153157"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-021-06514-x"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06133-y"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-015-3568-x"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2017.06.060"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511435637"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200810000-00001"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515578836"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2016.02.021"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2018.10.008"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197805000-00038"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465030310021801"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2009.01.015"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-3055-9"},{"key":"e_1_2_13_28_1","unstructured":"American Medical Association BL G Standard Nomenclature of Athletic Injuries 1966."},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-022-06057-3"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354659101900107"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2014.06.031"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506298110"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.24311"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2023.03.002"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-2856-1"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514561435"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05436-z"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.OA.20.00106"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.04.008"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.3.170035"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.34.3.227-a"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-011-2061-1"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12522"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200903000-00004"},{"issue":"8","key":"e_1_2_13_45_1","first-page":"1120","article-title":"Operative Versus Non\u2010Operative Treatment of Recent Injuries to the Ligaments of the Knee. A Prospective Randomized Study","volume":"69","author":"Sandberg R.","year":"1987","journal-title":"Journal of Bone and Joint Surgery. American Volume"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200402000-00008"},{"issue":"4","key":"e_1_2_13_47_1","first-page":"204","article-title":"Management of the Patient With an ACL\/MCL Injured Knee","volume":"3","author":"Mangine R. E.","year":"2008","journal-title":"North American Journal of Sports Physical Therapy"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517690525"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70234","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.70234","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70234","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T09:26:18Z","timestamp":1768296378000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.70234"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,26]]},"references-count":47,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/os.70234"],"URL":"https:\/\/doi.org\/10.1111\/os.70234","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,26]]},"assertion":[{"value":"2025-06-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}