MCL Reconstruction Surgeon in Farmington, CT
A direct impact to the knee can cause an injury to the medial collateral ligament (MCL) leading to minor sprain and pain, swelling, a partial or complete tear of the ligament or joint instability. Lee Pace, MD provides diagnosis and minimally-invasive MCL reconstruction surgery in Farmington, CT. Lee Pace, MD also provides highly specialized care during and after the surgery. Contact Lee Pace, MD’s office for an appointment today!
What is MCL Reconstruction?
MCL reconstruction is a surgical procedure in which a tendon graft is utilized to reconstruct the injured MCL.
MCL Anatomy
The medial collateral ligament (MCL) is one of four major ligaments of the knee that connects the femur (thighbone) to the tibia (shinbone). It is present on the inside of the knee joint and helps stabilize the knee.
MCL Injury – Strains and Tears
An injury to the MCL may occur as a result of direct impact to the knee. An MCL injury can result in a minor stretch (sprain), or a partial or complete tear of the ligament.
Symptoms of MCL Injuries
The most common symptoms following an MCL injury include pain, swelling, and joint instability.
Diagnosis of MCL Injuries
An MCL injury can be diagnosed with a thorough physical examination of the knee and diagnostic imaging tests such as X-rays, arthroscopy and MRI scans. X-rays may help rule out any fractures. In addition, your surgeon will perform a valgus stress test to check for stability of the MCL. In this test, the knee is bent approximately 30° and pressure is applied on the outside surface of the knee. Excessive pain or laxity is indicative of medial collateral ligament injury.
Management of MCL Injuries
If the overall stability of the knee is intact, your surgeon will recommend non-surgical methods including ice, physical therapy and bracing to treat the injury.
Surgical reconstruction is rarely recommended for MCL tears, but may be necessary if your injury fails to heal properly and you have residual knee instability. These cases are often associated with other ligament injuries. If surgery is required, a ligament repair may be performed, with or without reconstruction with a tendon graft, depending on the location and severity of the injury.
Indications For MCL Reconstruction
Medial collateral ligament reconstruction is indicated for chronic MCL instability despite appropriate non-surgical treatment or highly unstable MCL injuries that can occur in conjunction with other knee ligament injuries.
MCL Reconstruction Procedure
The procedure is performed under general anesthesia. An incision is made on the inner part of the knee over the native MCL. The appropriate graft, typically an allograft, is then fixed with modern implants on the femur and tibia.
Your surgeon will make an incision over the medial femoral condyle.
Care is taken to move muscles, tendons, and nerves out of the way.
The donor tendon is usually harvested from the Achilles tendon.
The soft tissue around the femur is debrided to assist in the insertion of the Achilles bone plug.
For placing the graft, a tunnel is created from a guide pin to the anatomic insertion of the MCL on the tibia, using the index finger and surgical scissors.
The Achilles tendon graft is inserted in the femoral tunnel and fixed using screws.
The MCL graft is made taut, with the knee at 20° flexion under varus stress, and fixed to the tibia with a screw and a spiked washer.
The incision is closed with sutures and covered with sterile dressings.
If you would like to have additional information on the treatment of MCL injury or would like to learn more about MCL reconstruction, please contact Lee Pace, MD, serving the communities of Farmington, CT.
