Digital Exclusive Review ArticlesManagement of Acute Combined ACL-Medial and Posteromedial Instability of the KneeMedvecky, Michael J. MD*; Tomaszewski, Paul MD†Author Information *Department of Orthopaedics & Rehabilitation †Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT Disclosure: The authors declare no conflict of interest. Reprints: Michael J. Medvecky, MD, Department of Orthopaedics & Rehabilitation, Yale University School of Medicine, P.O. Box 208071, New Haven, CT 06520-8071. Sports Medicine and Arthroscopy Review: June 2015 - Volume 23 - Issue 2 - p e7-e14 doi: 10.1097/JSA.0000000000000067 Buy Metrics Abstract Medial collateral ligament (MCL) injuries are the most common ligamentous injury of the knee. The extent of injury can range from a minor first-degree (1-degree) sprain to an extensive third-degree (3-degree) sprain that can propagate across the knee, rupturing one or both cruciate ligaments, and result in a knee subluxation or dislocation. A common pattern involves the combined anterior cruciate ligament (ACL) and MCL injury that is the focus of this chapter. The vast majority of these combined medial-sided injuries are treated nonoperatively with delayed reconstruction of the ACL injury in athletically active individuals. The MCL and associated medial structures are carefully assessed on physical examination, and classification of injury is based upon abnormal limits of joint motion. In vitro cadaveric biomechanical testing has given us a better understanding of ligament deficiency and altered joint motion. Consistency in terminology is necessary for proper classification of injury and reproducible categorization of injury patterns to be able to compare both nonoperative and operative treatment of various injury patterns. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.