reliability

The 9 speed transmission used in the MDX has had problems in the other cars that use it so CR predicts the reliability will be worse than average. 2016 was the worst year for this.

"This isn't the only issue to strike nine-speed Honda and Acura models. In a series of service bulletins issued in September, the automaker warns of transmission end cover leaks on the 2015-2017 TLX, 2016-2017 MDX, 2016-2017 Pilot, and 2018 Honda Odyssey."

http://www.thetruthaboutcars.com/2017/11/nine-speeds-another-problem-hondas-gear-iest-transmission/

The 9 speed transmission was the problem. People have been reporting jerkiness and unrefinement. No car reviewer really likes this 9 speed transmission which has been used in so many other cars not just from Honda or Acura and it has been a source of problems in every application. The 10 speed in the Odyssey has been pretty reliable and is a much better transmission. There is a ticking noise some people have in the engine and there is no fix, but it's only a sound. Aside from the transmission the MDX is reliable.