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Arthroscopic video before and after MCL reconstruction
Pre stress view Stress view, note the joint opening on the inside
Injury to the ligament on the inside of the knee, the medial collateral ligament (MCL) is a common sporting injury. Most often the result of a contact injury (tackle) in rugby and football, there is immediate pain and often the player is unable to complete the game. The knee becomes gradually swollen and mobility is restricted.
The pain is usually localised to the inside of the knee.
These injuries are almost universally treated without surgery in a range of motion brace with early physiotherapy and the most important factor is regaining full extension of the knee (straightening). Most injuries recover by 4-6 weeks to full function.
Occasionally the ligament injury is associated with a meniscal tear or injury to another ligament within the knee or fails to heal with non operative treatment (physiotherapy with or without brace) and will require surgery.
Surgery involves using one of the inside hamstring tendons to recreate/augment the MCL with open surgery. The tendon is anchored to the main tibial insertion sites with small bio absorbable screws and drawn into a tunnel on the femur and held with a metal button or interference screw.
Following reconstruction the ligament is protected in a brace for 12 weeks during the initial rehab. Return to contact sport is in the region of 4-6 months following this type of surgery.
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