MCL (medial collateral ligament) repair or reconstruction is an operation to restore stability to the inner side of the knee after a significant MCL injury that has not healed with non-operative treatment.
An incision is made on the inner side of the knee. For acute repair, the torn ligament is reattached to bone with suture anchors. For chronic injuries, a tendon graft may be needed to reconstruct the ligament. The operation takes one to one and a half hours.
Most MCL injuries heal without surgery. Surgical repair or reconstruction is reserved for complete tears that remain unstable despite bracing and rehabilitation, particularly when combined with other ligament injuries (multi-ligament knee injury).
Bracing and physiotherapy are effective for the majority of MCL injuries, including many complete tears.
MRI and stress X-rays. Pre-operative physiotherapy to restore range of motion.
Restoration of medial knee stability. Most patients achieve good stability and return to sport.
Particularly loss of full flexion.
Tenderness over the repair site.
Numbness on the inner calf and knee. Common with medial knee surgery.
The ligament may stretch or re-tear.
Wound infection.
DVT.
General or spinal anaesthesia with nerve block.
Hinged brace for six weeks. Crutches for four to six weeks. Progressive rehabilitation. Running at three to four months. Return to sport at six to nine months.
Reviews at two weeks, six weeks, three months, and six months.
The MCL has an excellent blood supply and heals well with bracing and rehabilitation. Surgery is only needed for injuries that fail to heal or are part of complex multi-ligament injuries.