MCL Repair — with 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° x6 weeks (brace open 0-90° in seated only); WBAT begins at 6 weeks; wean brace when quad control achieved

Key Restrictions

Flexion limited to 90° x6 weeks; TTWB x6 weeks (more restrictive than internal brace variant); no hamstring contraction x6 weeks; avoid valgus loads throughout; tibia in IR for all progressive exercises; no adduction x4 weeks; no stationary bike x6 weeks; running only straight line from 12 weeks

Timeline & Phases

3 phases: Phase I (0-6 wks, TTWB brace locked, flexion limited 90°, no stationary bike x6 wks), Phase II (6-12 wks, begin WBAT at 6 wks, wean brace/AD, CKC, stationary bike begins), Phase III (3-5 months, agility, sport-specific, straight line running from 12 wks)

Notes

No internal brace variant — more restrictive: TTWB x6 wks vs x2 wks, no bike x6 wks vs short crank from wk 2, running at 12 wks vs 8 wks; 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