{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T19:21:23Z","timestamp":1773602483390,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T00:00:00Z","timestamp":1631664000000},"content-version":"vor","delay-in-days":257,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T00:00:00Z","timestamp":1631664000000},"content-version":"vor","delay-in-days":257,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005713","name":"Technische Universit\u00e4t M\u00fcnchen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005713","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Anterior cruciate ligament (ACL) injuries are often combined with lesions of the medial collateral ligament (MCL). The aim of this study was to evaluate treatment outcome of combined acute ACL and MCL lesions using functional US and clinical examination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients aged\u2009&gt;\u200918 years undergoing primary ACL reconstruction with concomitant operative (group 1) or non\u2010operative treatment of the MCL (group 2) between 2014 and 2019 were included after a minimum follow\u2010up of 12\u00a0months. Grade II MCL injuries with dislocated tibial or femoral avulsions and grade III MCL ruptures underwent ligament repair whereas grade II injuries without dislocated avulsions were treated non\u2010operatively. Radiological outcome was assessed with functional US examinations. Medial knee joint width was determined in a supine position at 0\u00b0 and 30\u00b0 of knee flexion in unloaded and standardized loaded (=\u200915 Dekanewton) conditions using a fixation device. Clinical examination was performed and patient\u2010reported outcomes were assessed by the use of the subjective knee form (IKDC), Lysholm score, and the Tegner activity scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 40 patients (20 per group) met inclusion criteria. Mean age of group 1 was 40\u2009\u00b1\u200912 years (60% female) with a mean follow\u2010up of 33\u2009\u00b1\u200917\u00a0months. Group 2 showed a mean age of 33\u2009\u00b1\u20098 years (20% female) with a mean follow\u2010up of 34\u2009\u00b1\u200915\u00a0months. Side\u2010to\u2010side differences in US examinations were 0.4\u2009\u00b1\u20091.5\u00a0mm (mm) in 0\u00b0 and 0.4\u2009\u00b1\u20091.5\u00a0mm in 30\u00b0 knee flexion in group 1, and 0.9\u2009\u00b1\u20091.1\u00a0mm in 0\u00b0 and 0.5\u2009\u00b1\u20091.4\u00a0mm in 30\u00b0 knee flexion in group 2, with no statistically significant differences between both groups. MCL repair resulted in lower Lysholm scores (75\u2009\u00b1\u200919 versus 86\u2009\u00b1\u200915; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). No significant differences could be found for subjective IKDC or Tegner activity scores among the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A differentiated treatment concept in combined ACL and MCL injuries based on injury patterns leads to reliable postoperative ligamentous knee stability in US\u2010based and clinical examinations. However, grade II and III MCL lesions with subsequent operative MCL repair (group 1) result in slightly poorer subjective outcome scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Retrospective cohort study; Level III<\/jats:p><\/jats:sec>","DOI":"10.1186\/s40634-021-00401-7","type":"journal-article","created":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T03:02:42Z","timestamp":1631674962000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Ultrasound\u2010based evaluation revealed reliable postoperative knee stability after combined acute ACL and MCL injuries"],"prefix":"10.1002","volume":"8","author":[{"given":"Patricia M.","family":"Lutz","sequence":"first","affiliation":[{"name":"Department for Orthopedic Sports Medicine Technical University Munich Ismaningerstrasse 22 81675 Munich 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August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 August 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 September 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was obtained from the Ethics Committee of the technical University Munich. The study was approved by the institutional review board of the Technical University of Munich (235\/19 S). All procedures performed were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Was obtained from all subjects involved.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Andreas B. Imhoff is a consultant for Arthrosurface and Medi Bayreuth and receives royalties from Arthrex and Arthrosurface. All other authors declare that they have no competing interests related to this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"76"}}