PCL

Options for MCL

Repair

Reconstruction

Femoral repair of MCL

Non-operative Management

Natural history

Return to Sport

Shelbourne et al. Am J Sports Med 1999

- 133 patients with isolated PCL injuries followed for mean of 5 years

- 1/2 returned to sport at same level of play

- 1/3 returned to sport at lower level of play

https://pubmed.ncbi.nlm.nih.gov/10352760/

Agolley et al. Bone Joint J 2017

Issue

Avoiding convergence of ACL tunnel and femoral tunnels of popliteus / LCL

- drill LCL and popliteus femoral tunnels anterior to avoid more posterior ACL tunnel

- avoid drilling LCL femoral tunnel proximal, to avoid more proximal ACL tunnel

Moatshe et al. Am J Sports Med 2017

- avoiding tunnel convergence

- aim LCL and popliteus tunnel anteriorly 35^o

Anatomy

Size

2 x as strong as ACL

About the same length as ACL 38 mm

Cross sectional area 150% of ACL

13 mm diameter (thicker) 

2 Bundles

1.  Anterolateral

- most important

- double the size of the posteromedial

- tight in flexion

- try to reconstruct this bundle