Operative treatment of high-grade medial collateral ligament injury and chronic medial knee instability: a systematic review.
Arch Orthop Trauma SurgSep 30, 2026 (epub)
Yayi Xia, Yixiang Zhao, Xiping Dou et al.
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In 30 seconds
This systematic review assessed the operative treatment of high-grade medial collateral ligament (MCL) injuries and chronic medial knee instability, focusing on clinical phenotype rather than MCL grade. It included 35 reports, revealing that routine acute medial surgery during ACL reconstruction was not consistently superior. Selected repair targets showed potential for improved outcomes.
Key findings
- Routine acute medial surgery during ACL reconstruction was not consistently superior across heterogeneous grade III populations.
- Chronic symptomatic valgus and/or anteromedial rotatory insufficiency was most often treated with reconstruction.
- Directional improvement in objective stability and patient-reported outcomes was noted in case series.
Why it matters
Understanding the effectiveness of different surgical approaches for MCL injuries and chronic instability can guide clinicians in making informed decisions about treatment options, ultimately improving patient outcomes.