From the Guidelines
The frequency of an Anterior Cruciate Ligament (ACL) tear concomitant with a known Medial Collateral Ligament (MCL) full-grade tear is approximately 40-60% in patients with severe MCL injuries. When considering the management of combined ACL and MCL tears, it's essential to note that non-surgical treatment of the MCL injury can result in good patient outcomes, although surgical treatment of the MCL may be considered in select cases 1. The association between ACL and MCL tears exists due to the similar mechanisms of injury, typically involving valgus forces combined with rotation applied to the knee. Some key points to consider in the diagnosis and treatment of concomitant ACL and MCL tears include:
- The importance of thorough clinical examination, including valgus stress testing and anterior drawer or Lachman tests
- The use of MRI imaging to confirm the diagnosis
- The potential for chronic instability and accelerated joint degeneration if ACL tears are left untreated in the presence of MCL injuries
- The need for individualized treatment approaches, taking into account patient preferences and the severity of the injuries 1. Given the limited strength of recommendation for the management of combined ACL and MCL tears, practitioners should exercise clinical judgment and be alert for emerging evidence that clarifies or helps to determine the balance between benefits and potential harm 1.
From the Research
Frequency of ACL Tear Concomitant with MCL Full-Grade Tear
- The frequency of an Anterior Cruciate Ligament (ACL) tear concomitant with a known Medial Collateral Ligament (MCL) full-grade tear is not directly stated in the provided studies.
- However, a study by 2 found that out of 707 patients with combined ACL and MCL injuries, 15 patients showed spontaneous healing of ACL and MCL, with a mean healing time of 8.66 months.
- Another study by 3 compared bone bruising and intra-articular injuries in patients undergoing ACL reconstruction with and without MCL tears, but did not provide a specific frequency of ACL tears concomitant with MCL full-grade tears.
- A study by 4 found that 66% of patients with acute ACL disruption had concomitant meniscal tears, but did not specifically address the frequency of ACL tears concomitant with MCL full-grade tears.
- A review article by 5 stated that MCL injuries are common, with a reported incidence of 7.9% of all knee injuries, but did not provide information on the frequency of ACL tears concomitant with MCL full-grade tears.
Related Findings
- A study by 6 discussed the treatment of combined ACL and MCL injuries, suggesting that acute simultaneous surgical treatment of both ligaments may be potentially advantageous, but did not provide a specific frequency of ACL tears concomitant with MCL full-grade tears.
- The study by 2 suggested that valgus and external rotation injuries with dominancy of valgus force, apart from a MCL tear, may lead to proximal tear of ACL, and that the inflammation from the torn MCL can potentiate and stimulate the healing process of ACL.