{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T20:06:09Z","timestamp":1789589169195,"version":"build-2803163510"},"reference-count":77,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Injuries involving the medial collateral ligament (MCL), or combined injuries to both the anterior cruciate ligament (ACL) and MCL, are common and present considerable diagnostic and therapeutic challenges. Better understanding of MCL anatomy and biomechanics, especially in combined ACL\u2013MCL injuries, has driven the need for updated clinical examination and treatment approaches. The MCL complex comprises the superficial MCL (sMCL), deep MCL (dMCL), and the posteromedial complex (PMC), which includes the posterior oblique ligament (POL). Additional contributors to medial knee stability include the AMR and dynamic structures such as the semimembranosus, semitendinosus, and gracilis tendons. Biomechanically, the sMCL serves as the primary restraint against valgus loading and resists anterior tibial translation, particularly at higher degrees of knee flexion with external tibial rotation. The dMCL functions as a key stabiliser against external tibial rotation at low flexion angles and plays a significant role in anteromedial rotatory instability (AMRI), while the PMC\/POL primarily limits internal tibial rotation. Accurate diagnosis requires an integrated approach, including thorough patient history, detailed physical examination, magnetic resonance imaging (MRI), and selective use of stress tests. Clinical assessment remains essential, as overreliance on imaging alone may misrepresent injury severity. Evaluation of medial\u2010sided structures should be performed bilaterally and for each structure separately, based on their distinct biomechanical roles. The POL should be evaluated in full patient\u2010specific knee extension. Assessment for AMRI should involve testing both valgus laxity at 20\u00b0 of knee flexion, anteromedial drawer at 20\u00b0 and anterior tibial translation at 90\u00b0 with the tibia in neutral and then externally rotated. Findings of increased anterior tibial translation accompanied by excessive external tibial rotation relative to the contralateral side strongly indicate AMRI. This current concept article reviews the current literature and provides evidence\u2010based recommendations to develop guidance and optimize treatment strategies for isolated MCL injuries and combined MCL\u2013ACL injuries<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level V.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70588","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:39:03Z","timestamp":1789587543000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Current concepts in isolated and combined injuries of the medial collateral ligament complex\u2014Part I: Anatomy, biomechanics, clinical and radiological examination of the medial collateral ligament of the knee"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9901-6552","authenticated-orcid":false,"given":"Armin","family":"Runer","sequence":"first","affiliation":[{"name":"Department for Sports Orthopaedics TUM University Hospital, Rechts der Isar Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4489-1381","authenticated-orcid":false,"given":"Andrew","family":"Amis","sequence":"additional","affiliation":[{"name":"Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Smigielski","sequence":"additional","affiliation":[{"name":"Department of Descriptive and Clinical Anatomy, Center for Biostructure Research LIFE Medical Center Medical University of Warsaw Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5652-0692","authenticated-orcid":false,"given":"Elmar","family":"Herbst","sequence":"additional","affiliation":[{"name":"Department of Trauma, Hand and Reconstructive Surgery University of Muenster Muenster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8507-5735","authenticated-orcid":false,"given":"Christoph","family":"Kittl","sequence":"additional","affiliation":[{"name":"Department of Trauma, Hand and Reconstructive Surgery University of Muenster Muenster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6433-9896","authenticated-orcid":false,"given":"Guido","family":"Wierer","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Paracelsus Medical University Salzburg Salzburg Austria"},{"name":"Research Unit for Orthopaedic Sports Medicine and Injury Prevention (OSMI) ISAG, UMIT Hall Hall in Tirol Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8300-5653","authenticated-orcid":false,"given":"Nicolas","family":"Bouguennec","sequence":"additional","affiliation":[{"name":"Sports Clinic of Bordeaux\u2010M\u00e9rignac M\u00e9rignac France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2211-620X","authenticated-orcid":false,"given":"Riccardo","family":"Cristiani","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Section of Sports Medicine Karolinska Institutet Stockholm Sweden"},{"name":"Stockholm Sports Trauma Research Center (SSTRC) FIFA Medical Centre of Excellence Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4530-4580","authenticated-orcid":false,"given":"Christian","family":"Hoser","sequence":"additional","affiliation":[{"name":"Gelenkpunkt Sports and Joint Surgery Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Abermann","sequence":"additional","affiliation":[{"name":"Gelenkpunkt Sports and Joint Surgery Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Willinger","sequence":"additional","affiliation":[{"name":"Department for Sports Orthopaedics TUM University Hospital, Rechts der Isar Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"D'Ambrosi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Ortopedico Galeazzi Milan Italy"},{"name":"Dipartimento di Scienze Biomediche per la Salute Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric Hamrin","family":"Senorski","sequence":"additional","affiliation":[{"name":"Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4731-4333","authenticated-orcid":false,"given":"Alan","family":"Getgood","sequence":"additional","affiliation":[{"name":"Aspetar Orthopaedic and Sports Medicine Hospital Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8881-6212","authenticated-orcid":false,"given":"Volker","family":"Musahl","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9744-610X","authenticated-orcid":false,"given":"Simon","family":"Ball","sequence":"additional","affiliation":[{"name":"Fortius Clinic London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Williams","sequence":"additional","affiliation":[{"name":"Fortius Clinic London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3417-9307","authenticated-orcid":false,"given":"Gilbert","family":"Moatshe","sequence":"additional","affiliation":[{"name":"University of Oslo Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3193-6869","authenticated-orcid":false,"given":"Sebastian","family":"Siebenlist","sequence":"additional","affiliation":[{"name":"Department for Sports Orthopaedics TUM University Hospital, Rechts der Isar Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1591-7829","authenticated-orcid":false,"given":"Marc","family":"Strauss","sequence":"additional","affiliation":[{"name":"Idrettens Helsesenter Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Lind","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0169-8370","authenticated-orcid":false,"given":"Mirco","family":"Herbort","sequence":"additional","affiliation":[{"name":"Research Unit for Orthopaedic Sports Medicine and Injury Prevention (OSMI) ISAG, UMIT Hall Hall in Tirol Austria"},{"name":"OCM Klinik M\u00fcnchen  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5383-3370","authenticated-orcid":false,"given":"Kristian","family":"Samuelsson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Institute of Clinical Sciences The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5301-3919","authenticated-orcid":false,"given":"Christian","family":"Fink","sequence":"additional","affiliation":[{"name":"Research Unit for Orthopaedic Sports Medicine and Injury Prevention (OSMI) ISAG, UMIT Hall Hall in Tirol Austria"},{"name":"Gelenkpunkt Sports and Joint Surgery Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Robinson","sequence":"additional","affiliation":[{"name":"Knee Specialists Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"issue":"3","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"e291","DOI":"10.1016\/j.eats.2021.10.019","article-title":"MCL reconstruction using a flat tendon graft for anteromedial and posteromedial instability","volume":"11","author":"Abermann E","year":"2022","journal-title":"Arthrosc Tech"},{"key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"3709","DOI":"10.1007\/s00167-020-06139-6","article-title":"The bone attachments of the medial collateral and posterior oblique ligaments are defined anatomically and radiographically","volume":"28","author":"Athwal KK","year":"2020","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"3700","DOI":"10.1007\/s00167-020-06084-4","article-title":"The medial ligaments and the ACL restrain anteromedial laxity of the knee","volume":"28","author":"Ball S","year":"2020","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1177\/0363546508324969","article-title":"Medial collateral ligament injuries and subsequent load on the anterior cruciate ligament: a biomechanical evaluation in a cadaveric model","volume":"37","author":"Battaglia MJ","year":"2009","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"1960","DOI":"10.1177\/03635465241251462","article-title":"Load sharing of the deep and superficial medial collateral ligaments, the effect of a partial superficial medial collateral injury, and implications on ACL load","volume":"52","author":"Beel W","year":"2024","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1002\/ksa.12111","article-title":"Isometry of anteromedial reconstructions mimicking the deep medial collateral ligament depends on the femoral insertion","volume":"32","author":"Behrendt P","year":"2024","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"200","DOI":"10.2214\/ajr.184.1.01840200","article-title":"The \u201cfloating\u201d meniscus: MRI in knee trauma and implications for surgery","volume":"184","author":"Bikkina RS","year":"2005","journal-title":"Am J Roentgenol"},{"key":"e_1_2_12_9_1","first-page":"44","article-title":"The mechanics of the ligaments and menisci of the knee joint","volume":"23","author":"Brantigan OC","year":"1941","journal-title":"J Bone Joint Surg"},{"key":"e_1_2_12_10_1","first-page":"121","article-title":"The tibial collateral ligament: its function, its bursae, and its relation to the medial meniscus","volume":"25","author":"Brantigan OC","year":"1943","journal-title":"J Bone Joint Surg Am"},{"key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1080\/15438627.2022.2079981","article-title":"Clinical versus MRI grading of the medial collateral ligament in acute knee injury","volume":"32","author":"Brown JS","year":"2024","journal-title":"Res Sports Med"},{"key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.arthro.2023.05.029","article-title":"High prevalence of superficial and deep medial collateral ligament injuries on magnetic resonance imaging in patients with anterior cruciate ligament tears","volume":"40","author":"Cristiani R","year":"2024","journal-title":"Arthroscopy"},{"key":"e_1_2_12_13_1","doi-asserted-by":"crossref","DOI":"10.1177\/23259671251356698","article-title":"Delayed surgery, medial meniscus injury, and younger age are all factors significantly associated with high\u2010grade knee laxity before ACL reconstruction","volume":"13","author":"Cristiani R","year":"2025","journal-title":"Orthop J Sports Med"},{"key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1177\/0363546517737054","article-title":"Medial meniscus resection increases and medial meniscus repair preserves anterior knee laxity: a cohort study of 4497 patients with primary anterior cruciate ligament reconstruction","volume":"46","author":"Cristiani R","year":"2018","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"4080","DOI":"10.1007\/s00167-023-07472-2","article-title":"What it takes to have a high\u2010grade pivot shift\u2010focus on bony morphology","volume":"31","author":"Dadoo S","year":"2023","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"S83","DOI":"10.1148\/radiographics.20.suppl_1.g00oc05s83","article-title":"Three layers of the medial capsular and supporting structures of the knee: MR imaging\u2010anatomic correlation","volume":"20","author":"De Maeseneer M","year":"2000","journal-title":"Radiographics"},{"key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1302\/2058-5241.3.170035","article-title":"Isolated medial collateral ligament tears: an update on management","volume":"3","author":"Encinas\u2010Ull\u00e1n CA","year":"2018","journal-title":"EFORT Open Rev"},{"key":"e_1_2_12_18_1","doi-asserted-by":"crossref","first-page":"2356","DOI":"10.3390\/app11052356","article-title":"The effects of external loads and muscle forces on the knee joint ligaments during walking: a musculoskeletal model study","volume":"11","author":"Frigo CA","year":"2021","journal-title":"Appl Sci"},{"key":"e_1_2_12_19_1","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1016\/j.arthro.2018.10.114","article-title":"The presence of the arthroscopic \u201cfloating meniscus\u201d sign as an indicator for surgical intervention in patients with combined anterior cruciate ligament and Grade II medial collateral ligament injury","volume":"35","author":"Funchal LFZ","year":"2019","journal-title":"Arthroscopy"},{"key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"3754","DOI":"10.1007\/s00167-018-5013-4","article-title":"A polygon\u2010shaped complex appearance of medial patellofemoral ligament with dynamic functional insertion based on an outside\u2010in and inside\u2010out dissection technique","volume":"26","author":"Ge Y","year":"2018","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_21_1","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1177\/0363546516677728","article-title":"Should the ipsilateral hamstrings be used for anterior cruciate ligament reconstruction in the case of medial collateral ligament insufficiency? Biomechanical investigation regarding dynamic stabilization of the medial compartment by the hamstring muscles","volume":"45","author":"Herbort M","year":"2017","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_22_1","doi-asserted-by":"crossref","first-page":"2928","DOI":"10.1177\/03635465231187043","article-title":"The anterior fibers of the superficial MCL and the ACL restrain anteromedial rotatory instability","volume":"51","author":"Herbst E","year":"2023","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_23_1","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1177\/0363546504269591","article-title":"Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study","volume":"33","author":"Hewett TE","year":"2005","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_24_1","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1007\/s00167-013-2396-0","article-title":"Quantitative evaluation of the pivot shift by image analysis using the iPad","volume":"21","author":"Hoshino Y","year":"2013","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_25_1","doi-asserted-by":"crossref","first-page":"923","DOI":"10.2106\/00004623-197355050-00002","article-title":"The role of the posterior oblique ligament in repairs of acute medial (collateral) ligament tears of the knee","volume":"55","author":"Hughston JC","year":"1973","journal-title":"J Bone Joint Surg"},{"key":"e_1_2_12_26_1","doi-asserted-by":"crossref","first-page":"601","DOI":"10.3928\/0147-7447-19930501-14","article-title":"Anatomic variations of the pes anserinus: a cadaver study","volume":"16","author":"Ivey M","year":"1993","journal-title":"Orthopedics"},{"key":"e_1_2_12_27_1","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-642-45001-3","volume-title":"Das Knie: Form, Funktion und ligament\u00e4re Wiederherstellungschirurgie","author":"Jagodzinski M","year":"2016"},{"key":"e_1_2_12_28_1","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1186\/s12891-023-06732-z","article-title":"Magnetic resonance imaging of the knee anteromedial quadrant","volume":"24","author":"Jorge PB","year":"2023","journal-title":"BMC Musculoskelet Disord"},{"key":"e_1_2_12_29_1","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/j.arthro.2004.12.012","article-title":"Intra\u2010articular findings in the reconstructed multiligament\u2010injured knee","volume":"21","author":"Kaeding CC","year":"2005","journal-title":"Arthroscopy"},{"key":"e_1_2_12_30_1","first-page":"18","article-title":"Some aspects of functional anatomy of the human knee joint","volume":"23","author":"Kaplan EB","year":"1962","journal-title":"Clin Orthop"},{"key":"e_1_2_12_31_1","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s00167-017-4634-3","article-title":"Posterior cruciate ligament is twisted and flat structure: new prospective on anatomical morphology","volume":"26","author":"Kato T","year":"2018","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_32_1","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1177\/0363546519829384","article-title":"Dynamic restraints of the medial side of the knee: the semimembranosus corner revisited","volume":"47","author":"Kittl C","year":"2019","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_33_1","doi-asserted-by":"crossref","first-page":"3800","DOI":"10.1007\/s00167-020-06420-8","article-title":"Medial collateral ligament reconstruction graft isometry is effected by femoral position more than tibial position","volume":"29","author":"Kittl C","year":"2021","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_34_1","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1177\/0363546509349347","article-title":"Correlation of valgus stress radiographs with medial knee ligament injuries: an in vitro biomechanical study","volume":"38","author":"Laprade RF","year":"2010","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_35_1","doi-asserted-by":"crossref","first-page":"2000","DOI":"10.2106\/00004623-200709000-00016","article-title":"The anatomy of the medial part of the knee","volume":"89","author":"LaPrade RF","year":"2007","journal-title":"J Bone Joint Surg Am"},{"key":"e_1_2_12_36_1","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1302\/0301-620X.30B4.683","article-title":"Some anatomical details of the knee joint","volume":"30","author":"Last RJ","year":"1948","journal-title":"J Bone Joint Surg Br"},{"key":"e_1_2_12_37_1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/1749-799X-5-69","article-title":"Morphology of the medial collateral ligament of the knee","volume":"5","author":"Liu F","year":"2010","journal-title":"J Orthop Surg"},{"key":"e_1_2_12_38_1","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1080\/000164700317393394","article-title":"Interaction between the ACL graft and MCL in a combined ACL+MCL knee injury using a goat model","volume":"71","author":"Ma CB","year":"2000","journal-title":"Acta Orthop Scand"},{"key":"e_1_2_12_39_1","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1177\/0363546516685312","article-title":"Comparison of ACL strain in the MCL\u2010deficient and MCL\u2010reconstructed knee during simulated landing in a cadaveric model","volume":"45","author":"Mancini EJ","year":"2017","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_40_1","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1177\/0363546510385999","article-title":"Management of medial\u2010sided knee injuries, part 1: medial collateral ligament","volume":"39","author":"Marchant MH","year":"2011","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_41_1","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1177\/0363546508323254","article-title":"Effects of medial meniscus posterior horn avulsion and repair on tibiofemoral contact area and peak contact pressure with clinical implications","volume":"37","author":"Marzo JM","year":"2009","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_42_1","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1007\/s00167-019-05770-2","article-title":"Osseous valgus alignment and posteromedial ligament complex deficiency lead to increased ACL graft forces","volume":"28","author":"Mehl J","year":"2020","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"4","key":"e_1_2_12_43_1","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.OA.21.00069","article-title":"Injury to the meniscofemoral portion of the deep MCL is associated with medial femoral condyle bone marrow edema in ACL ruptures","volume":"6","author":"Moran J","year":"2021","journal-title":"JBJS Open Access"},{"key":"e_1_2_12_44_1","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1007\/s00256-021-03932-3","article-title":"The association of bone bruising and grade of MCL injury in patients sustaining isolated MCL injuries","volume":"51","author":"Morgan C","year":"2021","journal-title":"Skeletal Radiol"},{"key":"e_1_2_12_45_1","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1007\/s00167-019-05579-z","article-title":"Ramp lesions of the medial meniscus are associated with a higher grade of dynamic rotatory laxity in ACL\u2010injured patients in comparison to patients with an isolated injury","volume":"28","author":"Mouton C","year":"2020","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_46_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/978-3-662-06475-7","volume-title":"Das Knie","author":"M\u00fcller W","year":"1982"},{"key":"e_1_2_12_47_1","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1302\/0301-620X.92B7.23559","article-title":"Injury to the proximal deep medial collateral ligament: a problematical subgroup of injuries","volume":"92","author":"Narvani A","year":"2010","journal-title":"J Bone Joint Surg Br"},{"key":"e_1_2_12_48_1","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1007\/s00167-014-2902-z","article-title":"Arthroscopic posteromedial drive\u2010through test in posterior cruciate ligament insufficiency: a new diagnostic test","volume":"23","author":"Nha KW","year":"2015","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_49_1","doi-asserted-by":"crossref","first-page":"721","DOI":"10.2106\/00004623-195032040-00001","article-title":"Surgical treatment of fresh injuries to the major ligaments of the knee","volume":"32","author":"O'Donoghue DH","year":"1950","journal-title":"J Bone Joint Surg Am"},{"key":"e_1_2_12_50_1","doi-asserted-by":"crossref","first-page":"3473","DOI":"10.1177\/03635465231198856","article-title":"The effect of lateral extra\u2010articular tenodesis in an ACL\u2010reconstructed knee with partial medial meniscectomy: a biomechanical study","volume":"51","author":"\u00d6zbek EA","year":"2023","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_51_1","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1002\/ksa.12110","article-title":"Valgus malalignment causes increased forces on a medial collateral ligament reconstruction under dynamic valgus loading: a biomechanical study","volume":"32","author":"Peez C","year":"2024","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_52_1","doi-asserted-by":"crossref","DOI":"10.1177\/23259671221134818","article-title":"Qualitative and quantitative assessment of the medial patellar retinaculum anatomy: the anteromedial side of the knee revisited","volume":"10","author":"Peez C","year":"2022","journal-title":"Orthop J Sports Med"},{"key":"e_1_2_12_53_1","first-page":"77","article-title":"MCL injuries of the knee: current concepts review","volume":"26","author":"Phisitkul P","year":"2006","journal-title":"Iowa Orthop J"},{"key":"e_1_2_12_54_1","doi-asserted-by":"crossref","first-page":"2698","DOI":"10.1007\/s00167-018-5306-7","article-title":"Triaxial accelerometer can quantify the Lachman test similarly to standard arthrometers","volume":"27","author":"Raggi F","year":"2019","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_55_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/0720-048X(95)00660-I","article-title":"Grading medial collateral ligament injury: comparison of MR imaging and instrumented valgus\u2010varus laxity test\u2010device. A prospective double\u2010blind patient study","volume":"21","author":"Rasenberg EIJ","year":"1995","journal-title":"Eur J Radiol"},{"key":"e_1_2_12_56_1","volume-title":"Anatomie des Menschen\u2014Lehrbuch und Atlas","author":"Rauber A","year":"2003"},{"key":"e_1_2_12_57_1","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1177\/0363546506289433","article-title":"The role of the medial collateral ligament and posteromedial capsule in controlling knee laxity","volume":"34","author":"Robinson JR","year":"2006","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_58_1","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1302\/0301-620X.86B5.14853","article-title":"The posteromedial corner revisited. An anatomical description of the passive restraining structures of the medial aspect of the human knee","volume":"86","author":"Robinson JR","year":"2004","journal-title":"J Bone Joint Surg Br"},{"key":"e_1_2_12_59_1","doi-asserted-by":"crossref","first-page":"2717","DOI":"10.1007\/s00167-021-06540-9","article-title":"The evaluation of Rolimeter, KLT, KiRA and KT\u20101000 arthrometer in healthy individuals shows acceptable intra\u2010rater but poor inter\u2010rater reliability in the measurement of anterior tibial knee translation","volume":"29","author":"Runer A","year":"2021","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_60_1","unstructured":"RunerA WackerleA DiNennaM MoyerB GambleW SmolinskiM et al.ACL deficiency increases medial collateral ligament strain under anterior tibial load.ORS 2025 Annual Meeting;2025;Phoenix Arizona USA."},{"key":"e_1_2_12_61_1","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1186\/s12891-015-0804-y","article-title":"Medial and lateral hamstrings and quadriceps co\u2010activation affects knee joint kinematics and ACL elongation: a pilot study","volume":"16","author":"Serpell BG","year":"2015","journal-title":"BMC Musculoskelet Disord"},{"key":"e_1_2_12_62_1","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1177\/0363546503261738","article-title":"The posteromedial corner of the knee: medial\u2010sided injury patterns revisited","volume":"32","author":"Sims WF","year":"2004","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_63_1","doi-asserted-by":"crossref","first-page":"211","DOI":"10.2106\/00004623-196850020-00001","article-title":"Rotatory instability of the knee. Its pathogenesis and a clinical test to demonstrate its presence","volume":"50","author":"Slocum DB","year":"1968","journal-title":"J Bone Joint Surg"},{"key":"e_1_2_12_64_1","doi-asserted-by":"crossref","first-page":"3143","DOI":"10.1007\/s00167-014-3146-7","article-title":"Ribbon like appearance of the midsubstance fibres of the anterior cruciate ligament close to its femoral insertion site: a cadaveric study including 111 knees","volume":"23","author":"\u015amigielski R","year":"2015","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_65_1","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1007\/s00276-011-0814-x","article-title":"The relationship between the medial collateral ligament and the medial meniscus: a topographical and biomechanical study","volume":"33","author":"Stein G","year":"2011","journal-title":"Surg Radiol Anat"},{"key":"e_1_2_12_66_1","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1177\/0363546515617454","article-title":"Posteromedial meniscocapsular lesions increase tibiofemoral joint laxity with anterior cruciate ligament deficiency, and their repair reduces laxity","volume":"44","author":"Stephen JM","year":"2016","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_67_1","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.arthro.2019.07.015","article-title":"Graft choice for anterior cruciate ligament reconstruction with a concomitant non\u2010surgically treated medial collateral ligament injury does not influence the risk of revision","volume":"36","author":"Svantesson E","year":"2020","journal-title":"Arthroscopy"},{"key":"e_1_2_12_68_1","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1016\/j.knee.2014.08.019","article-title":"Clinical features and injury patterns of medial collateral ligament tibial side avulsions: \u201cwave sign\u201d on magnetic resonance imaging is essential for diagnosis","volume":"21","author":"Taketomi S","year":"2014","journal-title":"Knee"},{"key":"e_1_2_12_69_1","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1177\/03635465241233705","article-title":"Hamstring tendon autograft is associated with increased knee valgus moment after anterior cruciate ligament reconstruction: a biomechanical analysis","volume":"52","author":"Tummala SV","year":"2024","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_70_1","doi-asserted-by":"crossref","DOI":"10.1177\/23259671231202767","article-title":"Contribution of the medial hamstrings to valgus stability of the knee","volume":"11","author":"Vermorel PH","year":"2023","journal-title":"Orthop J Sports Med"},{"key":"e_1_2_12_71_1","doi-asserted-by":"crossref","first-page":"56","DOI":"10.2106\/00004623-197961010-00011","article-title":"The supporting structures and layers on the medial side of the knee: an anatomical analysis","volume":"61","author":"Warren LF","year":"1979","journal-title":"J Bone Joint Surg"},{"key":"e_1_2_12_72_1","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1007\/s00776-004-0781-8","article-title":"Biomechanical function of the posterior horn of the medial meniscus: a human cadaveric study","volume":"9","author":"Watanabe Y","year":"2004","journal-title":"J Orthop Sci"},{"key":"e_1_2_12_73_1","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1007\/s00167-020-05947-0","article-title":"The superficial medial collateral ligament is the major restraint to anteromedial instability of the knee","volume":"29","author":"Wierer G","year":"2021","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_74_1","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1177\/0363546509335191","article-title":"Medial knee injury: part 2, load sharing between the posterior oblique ligament and superficial medial collateral ligament","volume":"37","author":"Wijdicks CA","year":"2009","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_75_1","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s00167-021-06514-x","article-title":"High incidence of superficial and deep medial collateral ligament injuries in \u2018isolated\u2019 anterior cruciate ligament ruptures: a long overlooked injury","volume":"30","author":"Willinger L","year":"2021","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_76_1","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1007\/s00167-021-06671-z","article-title":"Medial meniscal ramp lesions in ACL\u2010injured elite athletes are strongly associated with medial collateral ligament injuries and medial tibial bone bruising on MRI","volume":"30","author":"Willinger L","year":"2022","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_77_1","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1177\/03635465241234263","article-title":"Noninvasive and reliable quantification of anteromedial rotatory knee laxity: a pilot study on healthy individuals","volume":"52","author":"Willinger L","year":"2024","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_78_1","doi-asserted-by":"crossref","first-page":"3720","DOI":"10.1007\/s00167-020-06050-0","article-title":"Length\u2010change patterns of the medial collateral ligament and posterior oblique ligament in relation to their function and surgery","volume":"28","author":"Willinger L","year":"2020","journal-title":"Knee Surg Sports Traumatol Arthrosc"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70588","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ksa.70588","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70588","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:39:15Z","timestamp":1789587555000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.70588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,16]]},"references-count":77,"alternative-id":["10.1002\/ksa.70588"],"URL":"https:\/\/doi.org\/10.1002\/ksa.70588","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,16]]},"assertion":[{"value":"2025-12-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ksa.70588"}}