Knee Medial Collateral Ligament Augmentation With Bioinductive Scaffold: Surgical Technique and Indications

The medial collateral ligament (MCL) is the most commonly injured ligament of the knee; however, only a minority of cases require surgical intervention. Classically, isolated grade I and II MCL injuries are treated nonoperatively whereas isolated grade III injuries may be treated with surgery. High-grade MCL injuries are frequently associated with concomitant knee ligamentous injuries, particularly the anterior cruciate ligament. Nonetheless, MCL repair or reconstruction is generally reserved for patients with persistent valgus instability after failed nonoperative management. Synthetic and biological implants are increasing in popularity to augment repairs and reconstructions for biomechanical reinforcement and promotion of the native healing response to hasten rehabilitation. The BioBrace (Biorez, New Haven, CT) is a bioinductive scaffold composed of highly porous type I collagen and bioresorbable poly(L-lactide) microfilaments, providing an environment for soft-tissue regeneration and mechanical support. The purpose of this article is to describe the surgical technique and relative indications for the BioBrace in knee MCL ligament repairs and reconstructions.