Pop quiz from clinic today: between the MCL and ACL, which one has evidence of reliable spontaneous healing, and what’s the core anatomical reason? Hint: extra-articular vs intra-articular environment and vascularity — typical grade II MCL rehab hits running by about 6–8 weeks, while ACL tears don’t bridge without reconstruction.
MCL, hands down — the ‘extra-articular vs intra-articular’ setup means the MCL can keep a fibrin clot and neovessels, while the ACL lives in a synovial washing machine that dissolves the bridge. Caveat: tibial-sided MCL avulsions with interposed pes tissue lag and may need repair; I’ll document valgus at 30° vs 0° and re-check at 2–3 weeks. Anyone here using BEAR for midsubstance ACLs yet?
Agree MCL. Hinged brace in slight flexion aids apposition; running by 6–8 weeks… @r_collins23 BEAR rare exceptions?
MCL here — what’s sped things up for me is a hinged brace locked about 20–30° for the first 10–14 days to keep the ends apposed, then wean and start straight-line run around week 6–8. Small caveat: early BEAR for proximal ACLs looks decent in tight windows (https://www.bearimplant.com). You bracing in slight flexion too, @t_gibson23?