The medial collateral ligament (MCL / tibial collateral ligament) of the knee is a broad flat ligament running from the medial femoral epicondyle to the medial tibial flare. It has a superficial component (primary valgus restraint) and a deep component (meniscofemoral and meniscotibial ligaments attached to the medial meniscus). It is the primary restraint to valgus knee stress and is the most commonly injured knee ligament.
Resists valgus stress and provides static medial stability, preventing the knee from buckling inward.
MCL injuries are graded I (sprain, intact), II (partial tear, lax but firm endpoint), III (complete tear, no endpoint). Isolated MCL tears are managed conservatively with functional bracing — even complete tears heal reliably without surgery due to the excellent blood supply. MCL repair or reconstruction is reserved for combined ligament injuries (e.g., ACL + MCL, posterolateral corner + MCL). Valgus stress testing at 0 and 30 degrees knee flexion assesses the superficial and deep MCL respectively. MRI grades the injury and identifies associated pathology.
Valgus force injuries ranging from tender without instability (Grade I) to complete tear with valgus opening at 30° flexion (Grade III).
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