From Anatomy to Complex Reconstruction: A Modern Review on the Medial Collateral Ligament of the Knee



1 1 Twin Cities Orthopedics, Edina-Crosstown, Edina, MN, USA 2 University of Minnesota Medical School, Minneapolis, MN, USA

2 1 Twin Cities Orthopedics, Edina-Crosstown, Edina, MN, USA 3 Georgetown University School of Medicine, Washington, DC 20007, U.S.A.

3 1 Twin Cities Orthopedics, Edina-Crosstown, Edina, MN, USA


Medial knee injuries are prevalent, especially in young athletes. A detailed history and physical examination are
needed to accurately diagnose injuries to the superficial medial collateral ligament (sMCL), deep medial collateral
ligament (dMCL), and posterior oblique ligament (POL). The mechanism of medial knee injury often involves a
coupled valgus and external rotation force with pain and tenderness across the medial joint line. Valgus stress
radiographs assist with the diagnosis of medial knee injuries based on the quantitative extent of medial joint
gapping. Specifically, 3.2 mm of increased medial gapping is observed with an isolated grade-III sMCL injury and
greater than 9.8 mm of gapping indicates a complete medial knee injury. Nonoperative treatment is recommended
for grade-I and II medial knee injuries. Patients with chronic medial knee instability, or a complete tear of the medial
knee structures, may require operative treatment. Anatomic surgical techniques have proven to be highly effective
in restoring functional knee stability.
Level of evidence: V


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