Medial Collateral Ligament (MCL) Repair
The most common knee ligament injury is an injury to the medial aspect of the knee. There are three main anatomic structures on the medial side of the knee, with the medial collateral ligament (MCL) being the largest and strongest. A large number of isolated MCL medial knee injuries are due to sporting events. They can be either a contact or non-contact stress to the outside of their knee, which in turn stretches or tears the medial knee structures on the inside of the knee.
The grade of the medial knee injury is based upon the amount of tearing present and treatment options depend on the location of the tear and if other ligaments are concurrently injured.
• Grade I: partial MCL tear
• Grade II: near complete MCL tear
• Grade III: a complete MCL tear – the ligament is non-functional
Surgeons at Peninsula Bone & Joint Clinic will perform a MCL reconstruction on patients who exhibit a grade III tear. In addition, it is well recognized having any “looseness” of the medial knee structures can cause an ACL graft to fail. Thus, when there is a combined medial knee injury and ACL injury, it is important to make sure the MCL injury heals completely prior to the ACL reconstruction or it should be concurrently repaired or reconstructed.
In the case of very severe combined knee ligament injuries, especially with a PCL tear, a concurrent medial knee injury should undergo a repair, augmentation repair, or a complete medial knee reconstruction (MCL reconstruction surgery).
Treatment
Rarely, an injury to the MCL will require surgery. Surgery is necessary when the ligament is torn in such a way that it can’t repair itself. It’s also done when the MCL injury occurs with other ligament injuries.
Before your surgery, your surgeon may use arthroscopy to thoroughly examine the extent of your injury and to look for associated injuries inside your knee. Arthroscopy involves inserting a small, thin camera through a tiny incision, or cut. After the arthroscopic exam, your surgeon will make a small incision along the inner aspect of your knee. If your ligament is torn where it attaches to either your shinbone or your thighbone, your surgeon can use one of these to reattach it:
- large stitches
- bone staples
- a metal screw
- a device called a suture anchor
If the tear is in the middle of the ligament, your surgeon will stitch the ligament together.