Medial Collateral Ligament in the Multiligament Knee Injury: Diagnosis, Evaluation, Management, and Outcomes

The medial collateral ligament (MCL) is one of the four major ligaments of the knee and serves to withstand valgus forces. Multiligament knee injuries (MLKI) can often involve the MCL as one of the ligaments injured, especially through a mechanism with valgus stress among other mechanisms. Thorough physical examination and imaging are critical for evaluating the extent of MCL injury and other ligament injuries. Due to the potential limb threatening nature of MLKIs, it is also very important to evaluate for neurovascular injuries, intra-articular injuries, and fractures. There is still much ongoing discussion surrounding treatment, including role for non-operative treatment, surgical timing, surgical technique, and postoperative rehabilitation. Depending on the patient, MCL repair, MCL reconstruction, and various graft options can be considered.