We have changed our visitation policy for the safety of our patients and staff. Click here for the updated visitation policy and click here for information about COVID-19.

Lahey Health is now part of Beth Israel Lahey Health

(Tibial Collateral Ligament Repair)

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:

  • Spinal—You will be numb from the waist down.
  • General—You will be asleep during the procedure.

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:

Repair

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.

Rebuild

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

At the Care Center

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.

At Home

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:  https://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.

Revision Information