What is MCL Reconstruction?
MCL reconstruction is a minimally invasive surgical procedure in which a tendon graft is utilized to reconstruct the injured MCL.
MCL Anatomy
The medial collateral ligament (MCL) is one of four major ligaments of the knee that connects the femur (thighbone) to the tibia (shinbone). It is present on the inside of the knee joint and helps stabilize the knee.
MCL Injury – Strains and Tears
An injury to the MCL may occur as a result of direct impact to the knee. An MCL injury can result in a minor stretch (sprain), or a partial or complete tear of the ligament.
Symptoms of MCL Injuries
The most common symptoms following an MCL injury include pain, swelling, and joint instability.
Diagnosis of MCL Injuries
An MCL injury can be diagnosed with a thorough physical examination of the knee and diagnostic imaging tests such as X-rays, arthroscopy and MRI scans. X-rays may help rule out any fractures. In addition, your surgeon will perform a valgus stress test to check for stability of the MCL. In this test, the knee is bent approximately 30° and pressure is applied on the outside surface of the knee. Excessive pain or laxity is indicative of medial collateral ligament injury.
Management of MCL Injuries
If the overall stability of the knee is intact, your surgeon will recommend non-surgical methods including ice, physical therapy and bracing to treat the injury.
Surgical reconstruction is rarely recommended for MCL tears, but may be necessary if your injury fails to heal properly and you have residual knee instability. These cases are often associated with other ligament injuries. If surgery is required, a ligament repair may be performed, with or without reconstruction with a tendon graft, depending on the location and severity of the injury.
Indications and Contraindications of MCL Reconstruction
Medial collateral ligament reconstruction is indicated for chronic MCL instability despite appropriate non-surgical treatment.
Medial collateral ligament reconstruction is contraindicated for degenerative changes in the medial or lateral compartment, active infection, ligament instability, or presence of chronic diseases that can hamper surgical management or compliance to postoperative rehabilitation instructions.
