Is surgery ever needed for a MCL tear?
Some surgeons describe a so-called grade IV injury to the medial collateral ligament. This is also called a medial column injury, and involves injury to more ligaments than just the MCL. Whether or not to repair the MCL, even in these settings, is controversial. Some doctors prefer to allow all MCL injuries to heal without surgery, and some prefer to repair these most significant injuries to the MCL. No significant difference has been demonstrated in these patients.