Outcomes of combined anterior cruciate ligament and medial collateral ligament reconstruction of the anterior cruciate ligament and medial collateral ligament with 'floating meniscus sign': A minimum 2-year FU study.

Authors

Luis F Z Funchal, Eric Pasqualotto, Rafael Ortiz, Diego C Astur, Moises Cohen

Published in

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. Jul 13, 2025. Epub Jul 13, 2025.

Abstract

This cohort study aimed to evaluate the outcomes of patients with combined anterior cruciate ligament (ACL) and grade II medial collateral ligament (MCL) injuries who exhibited the floating meniscus sign during arthroscopy and were treated with ACL and medial compartment reconstruction surgery.
Patients with combined ACL and grade II MCL injuries who underwent ACL and MCL reconstruction surgery between January 2019 and December 2022 were included in this study. The instability was classified as a grade II MCL injury, based on findings from magnetic resonance imaging and clinical examination. The Tegner activity scale and Lysholm score were collected preoperatively, 6, 12, 24, 36, 48 and 60 months postoperatively. Additionally, the number of patients with ACL reconstruction failure or residual MCL laxity at each follow-up time point was recorded.
A total of 197 patients underwent simultaneous reconstruction of the ACL and grade II MCL injuries. The mean age was 29 ± 9 years, and 83% were male. Six cases of ACL reconstruction failure were observed over 60 months, with no residual MCL valgus laxity at the final follow-up. Significant improvements in both the Tegner activity scale and Lysholm knee scoring scale were noted at all follow-up points compared to preoperative scores (p < 0.001).
The floating meniscus sign proved to be a valuable finding in guiding the surgical management of combined ACL and grade II MCL injuries. Our results suggest that, in physically active patients presenting with this sign, performing both ACL and MCL reconstruction leads to excellent mid-term outcomes, with significant functional improvement and a low rate of graft failure or residual valgus instability. This supports the surgical indication of MCL reconstruction in selected grade II injuries when the floating meniscus sign is present, potentially preventing long-term instability and suboptimal recovery.
Level III, retrospective cohort study.

PMID:
40652377
Bibliographic data and abstract were imported from PubMed on 13 Jul 2025.

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