Editorial Commentary: Grade III Medial Collateral Ligament Management Strategies in Patients Having Anterior Cruciate Ligament Reconstruction Vary Depending on Injury Pattern and Patient Factors.

Management strategies for grade III medial collateral ligament (MCL) tears in patients having anterior cruciate ligament reconstruction include repair, reconstruction, nonoperative management, and all of the aforementioned plus suture tape augmentation. Not all MCL injuries, even grade III injuries, are similar. Proximal MCL injuries have a good capacity to heal with nonoperative treatment, whereas distal MCL avulsions are thought to benefit from early surgery. Furthermore, patient factors such as hyperlaxity and lower-limb coronal plane alignment are confounders. Moreover, the medial complex extends posteriorly to include the posteromedial capsule and anteriorly to the medial border of the patella tendon. The 3 key passive ligament restraints on the medial side of the knee are the superficial MCL, the deep MCL, and the posteromedial corner, including the postero-oblique ligament.