Medial (MCL) and Lateral (LCL) Collateral Ligament Tears: MCL Repair With Suture Augmentation

Medial (MCL) and Lateral (LCL) Collateral Ligament Tears: MCL Repair With Suture Augmentation

This surgical video demonstrates a repair of the medial collateral ligament, or MCL, with a suture augmentation technique to treat an MCL tear. Here, we see a left knee with the inner side of the knee on the left side of the screen. The surgeon begins by marking out where the incisions will be made to access the attachment sites of the MCL.

The surgeon first cuts through the skin to access the top of the MCL, and inserts an instrument called a punch into a guide to make a socket in the thighbone or femur. Next, the punch is removed, and a soft body anchor is inserted into the guide and tapped into the bone. The anchor has sutures already in place which are unraveled off the anchor inserter. The inserter and guide are pulled out of the knee. Pulling on the sutures balls up the anchor under the bone to hold it in place.

The large, flat blue SutureTape is moved off to the side and will be used later in the procedure. The surgeon uses the other set of sutures from the anchor to stitch the top of the MCL together. Pulling on the sutures tightens the repair and pulls the ligament closer to the anchor, holding it against the bone. The surgeon then ties knots to secure everything in place.

Next, a passageway is made under the skin along the length of the MCL. The surgeon makes an incision at the inner side of the shin bone or tibia and passes the blue SutureTape under the skin from the top incision to the bottom incision. This SutureTape will be positioned over the length of the MCL to provide additional support.

The surgeon then places a pin in the shin bone where the MCL attaches. The surgeon loops the SutureTape around the pin and bends and straightens the knee to achieve the correct tension of the SutureTape. The surgeon then uses a drill to make a socket in the shin bone, and uses an instrument called a tap to create screw threads for the hard body anchor.

The end of the SutureTape is passed through a guidewire, which is used to thread the SutureTape through the tip of the anchor. While applying tension to the SutureTape, the surgeon positions the anchor and taps the anchor into the socket. This tacks down the SutureTape to hold it in place. The surgeon then cuts the tails of the SutureTape and will close the skin incisions. The MCL repair is now complete.