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Medial Collateral Ligament (MCL) Tears


What is the medial collateral ligament?

There are four primary ligaments in your knee that hold the bones together and keep your knee stable.

Two of these ligaments are known as the collateral ligaments. The medial collateral ligament (MCL) is found on the medial (inside) part of the knee, and connects the femur to the tibia. It is responsible for providing stability when the joint moves from side-to-side, and can become injured from a direct blow to the outside of the knee, an accidental fall or landing awkwardly during athletic activities.

MCL injuries are graded on a scale similar to that of ACL injuries. Higher numbers indicate more severe injuries:

  • Grade 1 – strain or partial MCL tear
  • Grade 2 – near complete tear with mild knee instability
  • Grade 3 – complete MCL tear with a non-functional ligament and significant instability


What are the symptoms of an MCL tear?

The hallmark symptom of MCL injury is pain on the medial (inside) aspect of the knee. Some patients may have bruising and swelling of the soft tissue around the MCL. In more severe injuries, patients may experience more significant knee instability, pain and dysfunction.


How is an MCL Tear Diagnosed?

Following a complete physical examination and medical review, x-rays are commonly ordered to rule out fractures or any other bone related injury. A stress x-ray may be necessary to assess the amount of joint gapping and instability due to MCL insufficiency. Dr. Potts may also order an MRI scan to determine the severity of MCL injury and rule out any additional injuries.


What is the treatment?

Treatment of an MCL injury depends on the severity of injury, symptoms, and instability. Most grade 1-2 MCL injuries respond well to non-surgical treatment with a combination of bracing, ice, rest and physical therapy. 

In unstable grade 3 MCL tears, or those that don’t respond to initial non-surgical treatment, Dr. Potts may recommend surgery to fix the ligament. Surgery for MCL tears consists of either a repair or reconstruction of the torn MCL. During a primary repair, the torn ligament will be sutured together in order to promote healing. If reconstruction is necessary, the MCL will be rebuilt using a strong tendon graft from the patient (autograft) or from a donor (allograft).