Primary Repair of the Medial Collateral Ligament With Internal Bracing

The medial collateral ligament (MCL) is commonly injured in the setting of anterior cruciate ligament (ACL) injuries. Because the MCL has better healing capacity than the ACL, the general perception is that MCL injuries can be treated conservatively. Treating these injuries conservatively, however, can lead to residual valgus laxity. Furthermore, it delays time to surgery, which prevents acute treatment of concomitant ACL injuries using primary repair or acute reconstruction. Several treatment methods for MCL injuries have been proposed, including primary repair, augmented repair with autograft tissue, or primary reconstruction. In this surgical technique article, we present the technique of acute primary MCL repair with internal bracing with 2 limited incisions. With this technique, early surgical intervention is possible, and early rehabilitation is safe because of the internal bracing. Advantages include fast recovery, avoidance of muscle atrophy because of early mobilization, prevention of residual valgus instability, and maintenance of proprioception.