Mini-Open Short Superficial and Deep Medial Collateral Ligament Reconstruction of the Knee With Adjustable System

Successful medial collateral ligament (MCL) reconstruction depends on multiple anatomical and biomechanical factors. Various techniques have been described, ranging from isolated superficial MCL reconstructions to complex combined medial reconstructions. Despite the evolution of surgical approaches, residual valgus and rotational laxity persist in a significant number of patients following MCL reconstruction, especially at higher degrees of flexion. Part of these failures is attributed to suboptimal graft isometry, limited control of external tibial rotation, and insufficient graft tensioning during fixation. We describe a surgical technique for superficial and deep MCL reconstruction using a single-limb allograft construct with an adjustable-loop femoral button and dual tibial fixation through suture anchors.