Surgical Techniques for the Treatment of Medial Knee Complex Injuries: A Systematic Review
M.M. Azuma, P.S. Gomes, L.A. RamosObjective:
To synthesize the current scientific evidence on surgical techniques for the treatment of medial knee complex injuries through a systematic review of the literature.
Methods:
A systematic review was conducted in accordance with the PRISMA guidelines using the PubMed, Scopus, and Google Scholar databases (2015–2025). Sixteen original articles published in English (Q1/Q2 journals) were selected and categorized into four thematic axes: anatomic reconstruction, technical innovations, primary repair, and comparative studies.
Results:
Anatomic reconstruction proved to be effective, reducing mean valgus opening from 7.0–8.5 mm (preoperative) to 1.2–1.6 mm (postoperative) and improving the subjective IKDC score from 43.3 to 94.7. In chronic settings, isolated repair showed a ninefold higher risk of failure compared with reconstruction. Acute percutaneous repair with augmentation in multiligament injuries resulted in normal stability in 90% of cases and a median Lysholm score of 95.0. Capsular advancement techniques were associated with a higher rate of flexion loss (>10°) in 41.5% of patients.
Conclusions:
Chronicity and injury pattern determine the surgical approach: reconstruction is mandatory in chronic instability, whereas minimally invasive primary repair is safe and effective for selected acute injuries.