Treatment of ACL Tear with Concurrent Medial Collateral Ligament Tear of the Knee
This protocol addresses the combined presentation of an anterior cruciate ligament tear and a medial collateral ligament tear of the knee — a pattern requiring coordinated evaluation of both injuries to guide treatment and restore knee stability.
When ACL and MCL tears occur together, evidence supports that the MCL component can often be managed without surgery, with outcomes remaining favourable. However, the degree of MCL laxity is a key determinant of whether operative intervention on the MCL becomes appropriate, making thorough clinical assessment essential.
Management centres on ACL reconstruction, and graft selection is an important consideration for long-term graft integrity and outcomes. The decision pathway for the MCL injury — whether non-operative management suffices or whether surgical repair or reconstruction is warranted — depends on findings not fully captured here. The complete structured regimen covers the full decision algorithm.
- Knee joint stability
- ACL graft integrity
- Medial collateral ligament stability of the knee
References
- In patients with combined ACL and MCL tears, non-operative treatment of the MCL injury results in good patient outcomes, although operative treatment of the MCL may be considered in select cases.
- When performing an ACL reconstruction, surgeons should consider autograft over allograft to improve patient outcomes and decrease ACL graft failure rate, particularly in young and/or active patients.
- This study supports that combined ACL/MCL injuries with greater MCL laxity may benefit from MCL reconstruction at time of ACL reconstruction.