Two-year Functional Outcomes of Non-Surgical Treatment in Concomitant ACL and MCL Injuries: A Case-Control Study.

Abstract

The anterior cruciate ligament (ACL) is a common knee injury in high-intensity sports, which can cause early career loss in young athletes. Concomitant damage to other knee stabilizers may occur, such as the medial collateral ligament (MCL). Recent study showed that knee stability can increase without surgical intervention in patients with ACL and MCL injuries. Regarding the importance of functional tests in return to exercise prediction, this study aims to measure non-surgical approach's long-term outcome for concomitant ACL and MCL injuries with a focus on functional tests. This is a case-control study with a two-year follow-up. The case group consisted of patients who had provided written consent and completed their 2-year follow-up, and the control group was made up of healthy people who did not have any knee medical conditions and were matched by age, gender, and activity level. Physical examinations, Tegner and IKDC questionnaires, and knee MRI were conducted, and functional performance tests were performed after a 10-minute warm-up. The Lody's index (the ratio of injured to uninjured knee results) was calculated. The data were analyzed using independent t-test, one-way ANOVA, chi-squared test, and Fisher's exact test. The study involved 11 patients in each concomitant ACL and MCL injuries case and healthy control groups with a mean age of 32.4 and 28 years, respectively. None of the patients reported knee instability symptoms in the 2-year follow-up. More than half of the patients continued their sports field without re-injury, with no significant difference in activity levels between case and control groups. The six-meter hop test and single-leg hop test showed no significant difference between case and control groups (P-Value:0.326, 0.859), and no significant difference was observed in the three Carioca, Co-contraction, and Shuttle tests in the 2-year follow-up. Functional tests in ACL and MCL injuries revealed normal outcomes, implying a non-surgical approach for patients with proximal ACL tears, better knee stability, and no significant differences between the injured and control groups.