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Medial Collateral Ligament Injuries

The medial collateral ligament is the primary and major stabilizer of the medial (inner edge) of the knee joint. It originates at a central point on the medial femoral condyle (upper bone) and widens out to attach to the proximal tibia (lower bone).

Anterior view of the right knee

An excess valgus force in which the knee drifts towards the opposite knee and the foot in the opposite direction will produce an injury to the MCL. Depending on the severity of the injury, the medial collateral ligament sustain

  1. Grade I - A strain of the ligament.
  2. Grade II - A partial tear of the ligament
  3. Grade III - A complete tear and disruption of the ligament

The majority of medial collateral ligament tears can be treated conservatively; in other words without surgical intervention. This treatment can range from simple physiotherapy, painkillers and rest to the addition of various braces to protect and stabilise the medial collateral ligament while it heals.

In a Grade III or complete disruption of the medial collateral ligament, surgery can sometimes be necessary if it is in conjunction with other significant injuries. In this setting, the medial collateral ligament can either be repaired if the injury is treated very early or reconstructed. Reconstruction involves the use of graft tissue to reconstruct and reinforce the medial collateral ligaments. I perform this procedure open, and not arthroscopically, through small incisions on the medial or inner side of the knee.

For medial collateral ligament reconstruction, the graft choices are the same as for any other knee ligament reconstructions. This graft is typically hamstring graft harvested from the patient. Other options include allograft (tissue donor graft). These will be either tibialis tendons, Achilles tendons, or quadriceps tendons.


In a medial collateral ligament tear which does not need surgery, the return to the sport is very much determined by the grade of the injury. This can range between 2 and 12 weeks.

If surgical reconstruction is required, then the return to sport is between 3 and 9 months.

Physiotherapy decreases the swelling and inflammation, regains motion and maintains muscle activation.

The final phase of recovery is guided by a Biokineticist, to regain balance, power and control