Operative and Nonoperative Treatments of Medial Collateral Ligament Rupture with Early Anterior Cruciate Ligament Reconstruction

Abstract

Nonoperative and operative treatments of medial collateral ligament injuries lead to equally good results. Medial collateral ligament ruptures need not be treated operatively when the anterior cruciate ligament is reconstructed in the early phase.

Posterolateral and Posteromedial Corner Injuries of the Knee

“…Combined ACL-PCL injuries with medial supporting structure involvement occur with equal or greater frequency than on the contralateral side. 6,[96][97][98][99] Usually an isolated MCL injury is treated conservatively, but the presence of a simultaneous posteromedial corner injury may require surgical intervention because of the potential for AMRI. An accurate evaluation of the PMC at imaging is imperative to guide the clinical and surgical management.…”

Surgical approach to the posteromedial corner: indications, technique, outcomes

“…Isolated injury to the MCL complex will typically heal with favorable results without operative intervention, especially in the instance of grade I or grade II injuries [29,[35][36][37][38]. The extra-articular location of the MCL allows the superficial MCL the potential to heal primarily, without repair or reconstruction [10,39].…”

“…This is thought to be in contrast to the ACL, which is constantly bathed in synovial fluid and has limited blood supply due to its intra-articular location, thereby limiting its healing potential [10,39]. Complete disruption of the MCL (grade III injury) is often associated with injury to another ligament, most often the ACL [10,13,29,38]. There is significant controversy when dealing with combined ACL and MCL injuries among the literature.…”

“…There is significant controversy when dealing with combined ACL and MCL injuries among the literature. Often the ACL is reconstructed and the MCL is left to heal primarily with some success [38][39][40]. Some recent concern has developed with following this method.…”

“…Some recent concern has developed with following this method. Multiple studies have shown patients to have greater anterior to posterior translation at 90°and increased valgus laxity at 30°with these combined injuries when compared with isolated ACL patients [38,41]. In addition, increased valgus laxity with incomplete healing of the MCL complex has been shown to increase stress across the reconstructed ACL [1, 42•, 43].…”