Westermann RW, et al. - Between 2002 and 2008, investigators examined 3028 individuals to estimate changes in repair and nonoperatively managed grade III medial collateral ligament (MCL) injuries during anterior cruciate ligament (ACL) reconstruction. They recorded grade III MCL tears in 1.1% of cases: 16 operatively managed patients and 11 nonoperatively treated MCLs during ACL reconstruction. They observed reoperation rates for arthrofibrosis, 19% after repair and 9% after conservative management. Overall, they found clinical improvements in both operative and nonoperative management of MCL tears between study enrollment and 2-year follow-up. They reported assignment of MCL surgery during ACL reconstruction to cases with worse symptoms at enrollment and was also linked with worse outcomes at 2 years.