Anchor-Based Double-Row Suture-Bridge Repair for Stener-Like Distal Medial Collateral Ligament Lesions of the Knee.

Abstract

Stener-like distal injuries of the superficial medial collateral ligament (MCL) are characterized by displacement of the distal ligament stump superficial to the pes anserinus fascia, preventing anatomic healing and resulting in persistent valgus and anteromedial rotatory instability. This technical note describes a reproducible anchor-based double-row, suture-bridge repair for Stener-like MCL lesions that restores the native tibial footprint and provides a low-profile augmentation. Following medial exposure, the distal superficial MCL is mobilized, interposed pes tissue is released, and the tibial footprint is prepared to a bleeding cancellous bed. A proximal all-suture anchor is placed approximately 12 mm distal to the joint line, a second all-suture anchor is inserted 6 cm distal to the joint line, and suture limbs are incorporated into a 4.75 mm knotless anchor to create a suture-bridge construct that compresses the ligament over a broad contact area. This configuration is designed to replicate the native flat tibial insertion, restore valgus restraint, and enhance resistance to anteromedial rotatory loads without graft harvest or multiple tunnels. The described technique provides a simplified, anatomic, and low-profile option for treating Stener-like distal MCL injuries and may improve biomechanical restoration and clinical outcomes.