A systematic review of distal medial collateral ligament Stener-like lesion: Good clinical and functional outcomes of surgical treatment

Purpose: This study aimed to systematically evaluate the existing literature to account for the clinical and functional outcomes, complications and rate of return to sports among patients treated for distal medial collateral ligament (MCL) lesions that are isolated or associated with other knee ligament injuries. Methods: A systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included were studies that reported postoperative clinical and functional outcomes in patients who had undergone surgery for an isolated or combined distal MCL lesion for medial knee instability. The authors evaluated surgical technique, rehabilitation protocol, postoperative outcomes (Lysholm, IKDC and Tegner scores and valgus stress radiograph), and return to sports and complication rates across the included studies. Results: A total of 70 patients (55 male, 15 female) were included. The mean age at surgery was 26.9 ± 8.2 years. The mean time from injury to surgery was 3.9 ± 3.0 weeks, while the mean follow-up was between 6 and 68 months, with a mean of 45.8 ± 21.4 months. A total of seven (10%) complications were reported and six (8.6%) revision surgeries. The mean Lysholm score on 27 (38.6%) patients was 87.2 ± 7.3, while IKDC2000 was reported only in one study was 62. Regarding return to sport, five articles reported a full return to sports activity after 6–9 months, while when return to sports was evaluated by Tegner reporting a mean value of 7.8 ± 2.4 (range: 3–10). Conclusion: Notwithstanding conflicting data, most patients who have undergone distal MCL lesion surgical treatment, either in isolation or associated with knee ligamentous injuries, achieve satisfactory clinical and functional outcomes, a low rate of postoperative complications, and a high rate of return to recreational sports. Level of Evidence: Level V, systematic review.