Medial collateral ligament reconstruction with allograft using a double-bundle technique

Abstract

Medial collateral ligament (MCL) reconstruction has been a topic of controversy in regard to the need for surgical reconstruction as well as the type of surgical reconstruction to be performed. Combined anterior cruciate ligament (ACL) and MCL reconstruction has been found to be associated with a higher incidence of postoperative arthrofibrosis than isolated ACL reconstruction; performing these reconstructions in a staged format has been proposed to avoid this devastating complication. We present a technique for MCL reconstruction that physiometrically re-establishes both anterior and posterior stabilizing components of the MCL and is performed with a limited soft-tissue dissection. This technique can easily be combined with an ACL allograft or hamstring reconstruction without need for staged or significantly delayed procedure. The technical details of this technique allow for stable fixation of an allograft reconstruction to allow for immediate postoperative knee range of motion with low patient morbidity because of the limited surgical approach.