Medial Collateral Ligament (MCL)
The Medial Collateral Ligament (MCL) is the main ligament on the medial side of the knee (the part of the knee nearest to the other knee). It is the most frequently injured ligament, often when a force (such as another football player) forces the foot out to the side. Although it is often injured, it also usually heals by itself. However, the knee needs to be protected whilst it is healing. This is usually done with a brace. An MRI scan will help to confirm a diagnosis, and to aid a surgical repair in a severe injury. However, the examination of the knee is the most important method of ensuring the diagnosis, and the prognosis. As with all knee injuries it is a combination of the history of the incident, the examination and the scans and/or x-rays that guide the treatment. No treatment should be based on the scan alone.
Operations to reconstruct the MCL can be very challenging. The MCL sometimes ruptures, but it usually just stretches. It is a very broad ligament with many different attachments to the knee. It is impossible to get a truly anatomical reconstruction. As well as the MCL, there is a complex of structures called the Posterior Oblique Ligament that can also be injured. This usually needs to be reconstructed as well. The method I prefer is to tighten (or plicate) the existing ligament and then augment the repair with a tough artificial graft called LARS (Ligament Augmentation and Reconstruction System).