Modified Anatomical Reconstruction of the Medial Collateral Ligament With Tibial Sling Bone Tunnels and Double-Bundle Semitendinosus Tendon

TL;DR

A new minimally invasive surgical technique is described for reconstructing the medial collateral ligament of the knee using a semitendinosus tendon graft.

Contribution

The novel approach uses a double-bundle semitendinosus tendon graft with tibial sling bone tunnels for MCL reconstruction.

Findings

The technique involves detailed preoperative assessment and uses interference screw fixation on the femur.

It offers increased graft strength and lower surgical morbidity for patients with severe MCL injuries.

The method is promising for improving knee stability, especially in cases with concomitant ACL injuries.

Abstract

This article describes a modification of an surgical technique for the anatomical reconstruction of the superficial medial collateral ligament (MCL) of the knee using a semitendinosus tendon graft in a minimally invasive approach. The MCL often is the site of severe injuries, which can result in long-term complications such as instability. The detailed surgical technique begins with an examination under anesthesia and diagnostic arthroscopy for accurate injury assessment. The semitendinosus tendon is used as a graft and fixed in the tibial communicating tunnels, with interference screw fixation only on the femur, restoring the integrity of the MCL. The postoperative protocol involves a careful rehabilitation process, including weight-bearing restriction and gradual return to sports activities. This technique offers advantages such as increased graft strength and lower surgical morbidity, making it a viable option for patients with anteromedial instabilities and grade III MCL injuries, especially when there are concomitant anterior cruciate ligament injuries. The anatomical reconstruction of the MCL with a double bundle and semitendinosus tendon graft is a promising technique that continues to be refined and studied in the quest for improved long-term outcomes in knee stability.

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