A medial collateral ligament (MCL) repair/reconstruction is performed on a grade lll sprain (full tear) of the lateral collateral ligament by either reattaching the ligament to the bone or replacing it with a tendon graft from the individual’s own body (autograft) or a donor tendon (allograft).
Overview of the procedure
The location of the tear in the MCL determines what type of surgery is to be performed
If the full tear is at the end of either side of the ligament where it attaches to the femur or the tibia then it is said to be “avulsed” off of the bone and the surgeon can reattached it to the bone by drilling a bone tunnel and using a screw or anchor into the bone to keep it in place. This is called a repair.
If the full tear is in the middle of the MCL ligament then the patient will need a tendon graft from another place in their own body (autograft) or a tendon graft from a cadaver donor body (allograft) to reconstruct and replace the torn ligament.
Either surgery can be gone arthroscopically or as an open procedure depending on circumstances but each surgery will take 1-2 hours
Pre-treatment considerations
Surgical repair or reconstruction of the MCL is suggested for athletes or highly active individuals with a grade III MCL sprain (a full tear)
Surgery is also indicated for individuals with damage to other structures in their knee, such as another ligament.
Post-treatment considerations and recovery
After surgery the patient will be put in a knee immobilizer and given crutches. The immobilization brace will be worn fort 6-8 weeks
Early motion is initiated on the same day or next day to begin to restore the range of motion of the knee and range of motion exercises are focused on in physical therapy for the first 6-8 weeks
After 6-8 weeks, physical therapy will begin to focus more on strengthening the muscles surrounding the knee
Full return to activity can be expected at 4-6 months.
Pros and benefits
Restores lateral stability and prevents valgus (medial) gapping between the bottom of the femur (the upper thigh bone) and the top of the tibia (the larger and more medial of the lower leg bones)
Improves function and mobility
Reduction in pain
Cons, risks, and possible side effects
Stiffness or decreased range of motion
Infection
Hyperlaxity
Nerve or blood vessel damage
Hardware irritation
Failure of graft
Blood clots
Need for further surgery
Arthritis later in life
