# 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.

## Key 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.