Management of medial collateral ligament injuries in the knee: an update and review.

The medial collateral ligament (MCL) is the most frequently injured ligament in the knee, with mild-to-moderate tears often going unreported to physicians. Medial collateral ligament injuries can result from both contact and noncontact sporting activities. The mainstay of treatment is nonoperative; however, operative management of symptomatic grade II and grade III injuries is considered when laxity and instability persist. The timing of surgical repair in the setting of a multiligament knee injury remains an area of controversy among surgeons, with proponents of early reconstruction of the anterior and posterior cruciate ligaments and nonoperative management of the MCL versus proponents of delayed reconstruction following nonoperative treatment of the MCL. Prophylactic bracing may continue to increase and evolve as bracing technology improves and athletic cultures change.