Pros And Cons Of MCL Surgery

Surgical MCL Repair vs. Non-Surgical

Kirk J. Hillstrom, Physical Therapist Assistant Student

Finlandia University

Surgical MCL Repair vs. Non-Surgical

With the rising popularity of sports; hockey, football, and, skiing, the Medial Cruciate Ligament of the knee, is the top-rated injury of the ligaments in the knee. It doesn’t necessarily have to include sports, but rather focuses on the valgus stress or force to the knee. A valgus force is blow with a severe force to the lateral portion of the knee, and is paired with the term sprain. The MCL constricts abduction of the knee, and constricts external rotation of the tibia on the femur. With this, the medical cruciate ligament functions to stabilize the knee against lateral or valgus forces.

In addition, with the “complete tibial side avulsion in athletes” (Phisitkul, James, Wolf, Amendola), I think surgery is needed, in this circumstance. In this situation, it is most likely needed because the tibia translated medially, also rupturing the MCL. First off, the tibia, needs to be realigned but then, the MCL ligament needs surgery because it is way out of alignment as well. In my opinion, if it was considered nonoperative in this scenario, the ends of the ligaments would have to be aligned in center with each other. In this case, they are not, so with surgery the collagen fibers can be sutured for alignment, which will allow for proper healing. But then also, because this part is a sport induced MCL injury, there is a good chance it does need

A few years ago, it was very controversial on which treatment was more effective. Again, it depends on the severity of the MCL injury and if in incorporates the ACl, not just grade. But present-day treatment, it is more likely that non-operative treatment be the best course of action. This is standard treatment with isolated grade I and II MCL injuries. Consisting of bracing, cold modalities, and controlled stress to work out the alignment of the collagen fibers. It is also said by professionals today, to try and avoid immobilization of the knee, as it can contribute to the knee becoming very stiff, and the collagen fibers in the ligament not healing as properly. But also stated, isolated grade III MCL injuries, are claimed to be rare and should be treated the same as a grade II injury. (N. Reha Tandogan, Asim Kavaalp)

In conclusion, surgical MCL repair vs non-surgical should be treated accordingly. It has to do with clinical findings of the injury. Having an MRI done, is the best course for determining the grade of the MCL injury. This can predict if surgery is needed, and depends if it is an isolated injury or not. If its ruled that it is a grade I or II isolated injury, non-surgical treatment, involving bracing and controlled stress will be the course of action. If a grade III injury is determined, it can be treated either way, but also