The medial collateral ligament (MCL) is located on the inside of the knee joint and is commonly injured.
Injuries to the MCL can be complex, and require expertise to both diagnosis and treatment. The areas associated with the “posteromedial corner” of the knee joint can include the posterior oblique ligament (POL), the postero medial capsule (PMC), the medial meniscus, the semi-membranosis tendon, and the MCL. The diagnosis of the exact injury will require detailed patient history and physical examination, as well as imaging studies.
Isolated injuries to the MCL are common, and can heal without surgery. In fact, the majority of MCL knee injuries do not require surgery at all and usually respond well to conservative treatment. However, these injuries can be severe, or may occur in association with an ACL injury, or other knee injuries, including a knee dislocation. It is important to highlight, that a cause of failure for ACL reconstruction can be associated with an untreated MCL injury. Your physician will determine if the posteromedial corner or MCL will require surgery. When surgery is required, options include MCL repair or reconstruction using a graft or multiple grafts. If MCL surgery is necessary, and additional injuries need to be treated, your physician will typically fix everything at one time.
During reconstructive surgery, your physician may use an arthroscopic technique which will consist of a small camera and tiny surgical tools to enter the knee joint so that the inside of the knee can be evaluated and treated. However, the MCL and PMC are on the outside of the knee joint, so open surgery is also required to treat the MCL and PMC. During MCL repair, the ligament may need to be reattached to the leg-bone (tibia) or thigh-bone (femur) using surgical sutures and/or suture anchors. During MCL and/or PMC reconstructive surgery, one or more grafts may be used in order to reconstruct the damaged MCL and POL. Several surgical treatment options may be considered depending on the pattern and degree of injury.
Following reconstructive surgery, protection of the knee and graft is critical. Weight bearing will be restricted at first, and therapy will be a supervised, progressive process. The patient and therapist will work under the guidance of your physician with a goal of achieving full recovery and return to activity in 3 to 6 months.