Treatment

Non surgical interventionsis

• considered in Grade I and II MCL injuries as well as isolated grade III injuries
• initially treated with rest, ice, compression and elevation to reduce initial pain and swelling
• patients are advised the bear weight as tolerated wearing a hinged brace to protect the knee from valgus movements. Early active range of motion is initiated to prevent stiffness (1)

Surgical interventions

• remains a controversial topic in MCL management
• generally considered in patients with grade III injury who fail to recover with non operative treatment resulting in chronic valgus instability (2)
• surgical options include:
• primary repair of the ligament
  • usually carried out within seven to ten days after the injury (3)
• autograft/allograft reconstruction
  • options for reconstruction of the ligament includes - hamstrings and Achilles

Reference:

• (1) Medial collateral ligament injuries of the knee: current treatment concepts, A, 2008. MCL Injuries of the Knee: Current Concepts Review. Current Review Musculoskelet Medicine, 1(2), 108-113
• (2) Duffy PS, Miyamoto RG. Management of medial collateral ligament injuries in the knee: an update and review. Phys Sportsmed. 2010;38(2):48-54
• (3) Phisitkul P et al. MCL injuries of the knee: current concepts review. Iowa Orthop J. 2006;26:77-90