Treatment of Combined ACL and MCL Tears in a Knee Joint

Anterior cruciate ligament (ACL) tears are commonly associated with medial collateral ligament (MCL) injuries.  This is due to the common mechanism of ACL injury involving the knee going into valgus with rotation.

Most medial collateral ligament tears have the potential to heal over the initial 6 weeks after the injury.

However in some type 2 to 3 tears of the MCL associated with ACL ruptures, the knee remains unstable to valgus stress due to permanent laxity of the MCL.

In these patients, reconstruction of the ACL alone may predispose to early reconstructed ACL graft failure due to MCL incompetence.

This is a patient who sustained both ACL and MCL tears in his left knee 3 months ago.  He continues to experience severe laxity of his left knee that affected his daily life.

This is a video of the examination before surgery.

In order to re-establish stability in his left knee, I decided to reconstruct both the ACL and MCL in one sitting.

This is the intra-operative surgery video:

It can be seen that the left knee’s ACL and MCL were stable after the reconstructions.

This patient’s left knee was placed in a knee brace for 1 month and he was asked to avoid placing weight on the left leg by using crutches for 1 month.

For more information on complex knee ligament injuries and reconstructions, please contact us at +65-683 666 36 or email

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