MCL Repair — with Internal Brace and Ipsilateral Hamstring Autograft Augmentation

Mammoth Orthopedic Institute / Sierra Park PT · Brian B. Gilmer MD (US Ski Team Physician); Karly M. Dawson PA-C; Ariel Duvall…

Weight-Bearing

TTWB brace locked 0° x2 weeks; WBAT brace locked 0° wks 2-6; wean brace/AD at 6 weeks when quad control achieved

Key Restrictions

PROM 0-90° x2 weeks then progress to full ROM by 6 weeks; no hamstring contraction x6 weeks; avoid valgus loads throughout; tibia in IR for all progressive exercises; no adduction x4 weeks; no planting/twisting; stationary bike allowed from 2 weeks (short crank)

Timeline & Phases

3 phases: Phase I (0-6 wks, TTWB x2 then WBAT brace locked, PROM 0-90° x2 wks then full ROM by 6 wks, stationary bike short crank from wk 2), Phase II (6-12 wks, wean brace/AD, CKC, running from wk 8), Phase III (3-5 months, agility, sport-specific, RTS repair 5 months / reconstruction 6 months)

Notes

Internal brace variant allows earlier bike (wk 2 short crank) and earlier running (wk 8) vs non-internal-brace variant (no bike x6 wks, running wk 12); references Cincinnati Sports Medicine and Orthopedic Center 2016; Ariel Duvall PT DPT; RTS for repair at 5 months, reconstruction at 6 months; quad strength ≥90% uninvolved required

Surgeon / Author

Brian B. Gilmer MD (US Ski Team Physician); Karly M. Dawson PA-C; Ariel Duvall PT DPT