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Minimally-Invasive, Retensionable, Onlay Double-Bundle Medial Collateral Ligament Reconstruction.

Adam W Anz¹, Garrett Waller¹, Mark Callanan¹

¹Andrews Research & Education Foundation, Gulf Breeze, Florida, USA.

Video Journal of Sports Medicine

|May 5, 2026

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This study presents a minimally-invasive double-bundle reconstruction for the superficial medial collateral ligament (sMCL), the most frequently injured knee ligament. The technique restores medial knee stability without compromising hamstring function.

Area of Science:

Orthopedic Surgery
Sports Medicine
Knee Ligament Reconstruction

Background:

The superficial medial collateral ligament (sMCL) is the most commonly injured knee ligament.
It is frequently injured concurrently with anterior cruciate ligament (ACL) tears.
Current techniques aim for less invasive approaches while preserving hamstring function.

Purpose of the Study:

To describe a minimally-invasive, double-bundle reconstruction technique for the sMCL.
To evaluate the efficacy of this technique in restoring medial knee stability.
To assess the impact on hamstring function.

Main Methods:

Utilizes an anterior tibialis allograft, knotless all-suture anchors, and an adjustable-loop suspensory fixation device.
Involves creating a distal tibial bone bed and a femoral reconstruction socket.

Keywords:

medial collateral ligament reconstruction multiligament knee injuries

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Fixation is achieved distally with suture anchors and proximally with a suspensory device, tensioned under arthroscopic guidance.

Main Results:

The technique has been clinically performed for 7 years by the senior author.
No reoperations or revision surgeries have been required in the senior author's practice.
The method effectively restores medial knee stability.

Conclusions:

This minimally-invasive, retensionable, onlay double-bundle MCL reconstruction effectively restores medial knee stability.
The technique does not compromise hamstring function, preserving dynamic medial knee stability.
It offers a viable surgical option for specific MCL injuries.