From the Research
Surgical intervention for a Grade 3 Medial Collateral Ligament (MCL) injury is typically indicated only in specific circumstances, such as when there are multiple ligament injuries, particularly when the anterior cruciate ligament is also torn, as evidenced by a study published in 2019 1. When considering the management of Grade 3 MCL injuries, it's crucial to assess the presence of concomitant ligament injuries, as these can significantly influence the prognosis and treatment approach.
- The standard non-surgical approach for isolated Grade 3 MCL injuries involves a period of immobilization in a hinged knee brace for 2-3 weeks, followed by progressive range of motion exercises and gradual return to activities over 6-12 weeks, as supported by studies such as the one published in 2006 2 and 3.
- Physical therapy focusing on quadriceps and hamstring strengthening is essential during rehabilitation.
- Surgery, when needed, typically involves primary repair of the ligament or reconstruction using autograft or allograft tissue, with a study from 2020 4 highlighting satisfactory clinical and functional outcomes following acute repair of Grade III distal MCL avulsions in multiligamentous knee injuries. However, the preference for conservative management stems from the MCL's good blood supply and inherent healing capacity, with surgical outcomes generally not superior to non-operative treatment for isolated injuries, as noted in the study from 2019 1. Recovery from MCL surgery typically requires 6-9 months before return to full athletic activities. Given the most recent and highest quality evidence, the decision to proceed with surgical intervention should be based on the presence of specific complicating factors, such as multiple ligament injuries or persistent instability, rather than the grade of the MCL injury alone 1.