Medial Collateral Ligament Reconstruction (MCL)
A surgical procedure to restore stability and function to the medial side of the knee
The MCL is one of the major stabilising ligaments of the knee, protecting it from excessive inward movement. Injuries to the MCL often occur due to direct impact to the outer knee or during activities that involve sudden changes in direction or twisting motions.
Common Reasons for MCL Reconstruction Surgery
- Severe or complete tears of the MCL that do not heal with non-surgical treatments.
- Chronic instability or persistent pain caused by an untreated or improperly healed MCL injury.
- Combined ligament injuries, such as damage to the ACL or PCL, requiring comprehensive knee reconstruction.
The primary goals of MCL reconstruction are to stabilise the knee, alleviate pain, and restore normal function.
Preparation for Surgery
Preparation includes a thorough evaluation by Dr Ben McGrath, with imaging studies such as X-rays or MRIs used to assess the extent of the injury and determine the best surgical approach.
Key Steps in Preparation:
- Consultation: Dr McGrath will explain the procedure, discuss potential risks and benefits, and address any questions.
- Pre-Surgical Instructions: Patients may need to fast before surgery and adjust medications, such as stopping blood thinners.
- Prehabilitation: Strengthening the surrounding muscles before surgery may improve recovery outcomes.
- Lifestyle Adjustments: Maintaining a healthy weight and stopping smoking can optimise surgical outcomes and recovery.
What Happens During the Surgery?
MCL reconstruction is typically performed under general anaesthesia using minimally invasive techniques where possible.
Surgical Steps:
- Incisions: Small incisions are made to access the damaged ligament.
- Graft Selection: A graft, often harvested from the hamstring or a donor source, is prepared to replace the damaged ligament.
- Placement and Fixation: The graft is secured to the femur and tibia using screws or other fixation devices, restoring the ligament’s function.
- Closure: The incisions are closed with sutures or adhesive strips, and the knee is bandaged for protection.
The procedure generally takes 1 to 2 hours, depending on the complexity of the injury.
Understanding the Risks
While MCL reconstruction is generally safe, it is important to understand the potential risks:
- Infection: At the incision sites or within the joint.
- Graft Failure: Rarely, the reconstructed ligament may not function as expected.
- Swelling and Stiffness: Temporary inflammation or reduced range of motion.
- Blood Clots: Rare but possible in the lower limbs.
- Nerve or Vessel Injury: Extremely rare but a potential risk during surgery.
Dr McGrath follows rigorous safety protocols to minimise these risks and ensure patient safety.
What to Expect After Surgery
Immediate Post-Operative Care:
- Pain Management: Mild to moderate discomfort is normal and can be managed with prescribed medications and regular icing.
- Assistive Devices: Crutches and a knee brace may be required to support the joint during the initial recovery phase.
- Discharge Instructions: Patients will receive clear guidance on wound care, activity restrictions, and follow-up appointments.
Rehabilitation and Recovery
Recovery from MCL reconstruction involves a structured rehabilitation plan tailored to the patient’s needs:
Phase 1: Early Recovery (Weeks 0–6)
- Goals: Protect the graft, reduce swelling, and restore range of motion (ROM).
- Activities: Partial weight-bearing with crutches, gentle ROM exercises, and cryotherapy.
Phase 2: Strength and Mobility (Weeks 6–12)
- Goals: Regain strength, mobility, and stability in the knee.
- Activities: Physiotherapy for strengthening the quadriceps and hamstrings, light cycling, and balance exercises.
Phase 3: Advanced Recovery (Months 3–6)
- Goals: Restore full function and prepare for daily activities or sports.
- Activities: Progressive resistance training, functional drills, and agility exercises.
Long-Term Outcomes
MCL reconstruction may help stabilise the knee, alleviate pain, and improve function. Long-term success depends on:
- Adherence to rehabilitation protocols.
- Regular follow-up appointments to monitor progress.
- Maintaining a healthy lifestyle, including low-impact activities to support joint health.
Most patients experience significant improvements in knee stability and mobility, allowing them to resume their daily activities or athletic pursuits.