{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:45:09Z","timestamp":1790286309417,"version":"4.1.0"},"reference-count":47,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,2,11]],"date-time":"2024-02-11T00:00:00Z","timestamp":1707609600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Historical MCL (medial collateral ligament) reconstruction (MCLR) techniques have focused on the superficial MCL (sMCL) to restore valgus stability while frequently ignoring the importance of the deep MCL (dMCL) in controlling tibial external rotation. The recent recognition of the medial ligament complex importance has multiple studies revisiting medial anatomy and questioning contemporary MCLR techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To assess whether (1) an isolated sMCL reconstruction (sMCLR), (2) an isolated dMCL reconstruction (dMCLR), or (3) a novel single-strand short isometric construct (SIC) would restore translational and rotational stability to a knee with a dMCL and sMCL injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Controlled laboratory study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Biomechanical testing was performed on 14 fresh-frozen cadaveric knee specimens using a custom multiaxial knee activity simulator. The specimens were divided into 2 groups. The first group was tested in 4 states: intact, after sectioning the sMCL and dMCL, isolated sMCLR, and isolated dMCLR. The second group was tested in 3 states: intact, after sectioning the sMCL and dMCL, and after single-strand SIC reconstruction (SICR). In each state, 4 loading conditions were applied at 0\u00b0, 20\u00b0, 40\u00b0, 60\u00b0, and 90\u00b0 of knee flexion: 8-N\u00b7m valgus torque, 5-N\u00b7m external rotation torque, 90-N anterior drawer, and combined 90-N anterior drawer plus 5-N\u00b7m tibial external rotation torque. Anterior translation, valgus rotation, and external rotation of the knee were measured for each state and loading condition using an optical motion capture system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>sMCL and dMCL transection resulted in increased laxity for all loading conditions at all flexion angles. Isolated dMCLR restored external rotation stability to intact levels throughout all degrees of flexion, yet valgus stability was restored only at 0\u00b0 of flexion. Isolated sMCLR restored valgus and external rotation stability at 0\u00b0, 20\u00b0, and 40\u00b0 of flexion but not at 60\u00b0 or 90\u00b0 of flexion. Single-strand SICR restored valgus and external rotation stability at all flexion angles. In the combined anterior drawer plus external rotation test, isolated dMCL and single-strand SICR restored stability to the intact level at all flexion angles, while the isolated sMCL restored stability at 20\u00b0 and 40\u00b0 of flexion but not at 60\u00b0 or 90\u00b0 of flexion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In the cadaveric model, single-strand SICR restored valgus and rotational stability throughout the range of motion. dMCLR restored rotational stability to the knee throughout the range of motion but did not restore valgus stability. Isolated sMCLR restored external rotation and valgus stability in early flexion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>In patients with anteromedial rotatory instability in the knee, neither an sMCLR nor a dMCLR is sufficient to restore stability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465231224477","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T02:25:50Z","timestamp":1707704750000},"page":"968-976","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Single-Strand \u201cShort Isometric Construct\u201d Medial Collateral Ligament Reconstruction Restores Valgus and Rotational Stability While Isolated Deep MCL and Superficial MCL Reconstruction Do Not"],"prefix":"10.1177","volume":"52","author":[{"given":"Kyle A.","family":"Borque","sequence":"first","affiliation":[{"name":"Houston Methodist Hospital, Houston, Texas, USA"},{"name":"Investigation performed at the Department of Orthopedic Surgery, UT McGovern Medical School, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuyang","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Texas Health Science Center at Houston, Houston, Texas, USA"},{"name":"Investigation performed at the Department of Orthopedic Surgery, UT McGovern Medical School, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"Dunbar","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Texas Health Science Center at Houston, Houston, Texas, USA"},{"name":"Investigation performed at the Department of Orthopedic Surgery, UT McGovern Medical School, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas D.","family":"Lanfermeijer","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Texas Health Science Center at Houston, Houston, Texas, USA"},{"name":"Investigation performed at the Department of Orthopedic Surgery, UT McGovern Medical School, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan W.","family":"Sij","sequence":"additional","affiliation":[{"name":"UT McGovern Medical School, Houston, Texas, USA"},{"name":"Investigation performed at the Department of Orthopedic Surgery, UT McGovern Medical School, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan E.","family":"Gold","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Texas Health Science Center at Houston, Houston, Texas, USA"},{"name":"Investigation performed at the Department of Orthopedic Surgery, UT McGovern Medical School, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabir K.","family":"Ismaily","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Texas Health Science Center at Houston, Houston, Texas, USA"},{"name":"Investigation performed at the Department of Orthopedic Surgery, UT McGovern Medical School, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew A.","family":"Amis","sequence":"additional","affiliation":[{"name":"Imperial College London, London, UK"},{"name":"Investigation performed at the Department of Orthopedic Surgery, UT McGovern Medical School, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitzi S.","family":"Laughlin","sequence":"additional","affiliation":[{"name":"Houston Methodist Academic Institute, Houston, Texas, USA"},{"name":"Investigation performed at the Department of Orthopedic Surgery, UT McGovern Medical School, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Kraeutler","sequence":"additional","affiliation":[{"name":"Houston Methodist Hospital, Houston, Texas, USA"},{"name":"Investigation performed at the Department of Orthopedic Surgery, UT McGovern Medical School, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Williams","sequence":"additional","affiliation":[{"name":"Fortius Clinic, London, UK; 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