Definition
MCL repair is done to rebuild or support the ligament. The MCL sits on the inside of the knee. It is attached to the bone of the thigh and lower leg. The MCL helps to keep the knee stable against outside forces.
Reasons for Procedure
Surgery may be needed if the ligament is damaged or weak. It may be done if:
- Ligament was injured and other treatment has not worked
- The MCL is torn from the bone
- Ligament is damaged by structural problems in legs
- The knee is unstable—it buckles, twists, or slips in and out of the joint
Possible Complications
Problems are rare, but all procedures have some risk. Your doctor will go over some possible problems such as:
- Bleeding
- Infection
- Blood clots
- Damage to nearby structures
- Stiffness, numbness, or other knee problems
The risk of problems is higher if you:
- Smoke
- Drink
- Have long-term diseases such as diabetes or obesity
What to Expect
Prior to Procedure
Leading up to the procedure:
- Talk to your doctor about the medicines you take. You may be asked to stop taking some medicines up to 1 week in advance.
- Arrange for a ride home from the hospital.
- Do not eat or drink anything after midnight before the procedure.
Anesthesia
Your doctor will talk to you about anesthesia options such as:
Description of the Procedure
The skin over the area will be cleaned. Small cuts are made in the knee. The doctor will pass tube-shaped tools into the cuts. One tube has a camera. It will send images to a screen so the doctor can see inside the knee. The repair work can be done in 1 of 2 ways:
The ends of the torn ligament are stitched together. The ligament is attached to the bone to secure it. Tendon from another area may be used to support to the repair.
The ligament may be too damaged to repair. In this case, it is replaced with a piece of tendon. Small holes are drilled into the bones. Screws will attach the tendon to the bone. Over time, bone will grow around the area. This will make it stronger.
The cuts are closed with stitches or staples. A bandage will cover the cuts.
How Long Will It Take?
About 2 hours
Will It Hurt?
Anesthesia will prevent pain during surgery. Your knee will be sore after the procedure. Medicine and knee support will help to ease pain.
Post-procedure Care
The care team will ice your knee. You will be given pain medicine.
You will be able to leave 1 to 2 hours after the procedure.
There will be some movement limits. Devices will help to support the knee so that you can move around. Full recovery can take a few months. Physical therapy will help to regain movement and strength.
Call Your Doctor
Call your doctor if any of these occur:
- Signs of infection such as fever or chills
- Redness, swelling, pain, bleeding, or drainage from the wounds
- Medicine is not helping your pain
- Ongoing nausea or vomiting
If you think you have an emergency, call for emergency medical services right away.
RESOURCES
American Medical Society for Sports Medicine https://www.amssm.org
OrthoInfo—American Academy of Orthopaedic Surgeons https://orthoinfo.org
CANADIAN RESOURCES
Health Canada https://www.canada.ca
When It Hurts to Move—Canadian Orthopaedic Foundation https://whenithurtstomove.org
References
Bonasia DE, Bruzzone M, et al. Treatment of medial and posteromedial knee instability: indications, techniques, and review of the results. Iowa Orthop J. 2012;32:173-183.
Knee ligament repair. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/knee-ligament-repair. Accessed June 14, 2020.
Management of medial collateral ligament (MCL) injuries. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T920537/Management-of-medial-collateral-ligament-MCL-injuries . Accessed June 14, 2020.
MCL reconstruction surgery. Sports Surgery Chicago website. Available at: https://sportssurgerychicago.com/mcl-surgery-reconstruction-westchester-oakbrook-hinsdale-il. Accessed June 14, 2020.
Trofa DP, Sonnenfeld JJ, et al. Distal knee medial collateral repair with suture augmentation. Arthrosc Tech 2018;7(9):e921-e926.