Combined Anterior Cruciate Ligament and Medial Collateral Ligament Knee Injuries: Anatomy, Diagnosis, Management Recommendations, and Return to Sport

  • Joshua L. Elkin
  • Edgar Zamora
  • Robert A. GalloEmail author
ACL: Risk Factors, Outcomes, Preventions (R Gallo, Section Editor)
Part of the following topical collections:
  1. Topical Collection on ACL: Risk Factors, Outcomes, Preventions


Purpose of review

The diagnosis and management of combined anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries have been a controversial topic for several decades. No single approach has proven optimal for treatment and there is no consensus between most specialists. This review seeks to describe and clarify the current state and the future of management.

Recent findings

Most authors agree on reconstructing of the ACL with non-operative management of the MCL in grade I and II injuries, respectively. However, controversy still exists about the optimal method of treating a combined ACL with higher grade MCL injuries.


Management should be customized based on acuity, injury grade, and specific goals for each patient. Future research with clinical outcomes may facilitate creating guidelines to optimize recovery.


Anterior cruciate ligament Medial collateral ligament Combined injuries 


Compliance with Ethical Standards

Conflict of Interest

Joshua L. Elkin, Edgar Zamora, and Robert A. Gallo have not received (or agreed to receive) from a commercial entity something of value (exceeding the equivalent of US$500) related in any way to this manuscript.

Robert A. Gallo received institutional research support from Aesculap for a novel cartilage scaffold trial. Dr. Gallo is a section editor for Current Reviews in Musculoskeletal Medicine.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Joshua L. Elkin
    • 1
    • 2
  • Edgar Zamora
    • 1
  • Robert A. Gallo
    • 2
    Email author
  1. 1.Department of Internal MedicineUPMC Pinnacle Harrisburg HospitalHarrisburgUSA
  2. 2.Department of Orthopaedics, Bone and Joint Institute, Milton S. Hershey Medical CenterPennsylvania State University College of MedicineHersheyUSA

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