Westermann RW, et al. - In this multicenter prospective longitudinal study involving patients who had unilateral primary anterior cruciate ligament (ACL) reconstruction, researchers assessed differences in grade III repair and nonoperatively managed medial collateral ligament (MCL) injuries during the reconstruction of ACL. For this analysis, they identified patients with concomitant grade III MCL injuries treated either operatively or nonoperatively. Data reported that arthrofibrosis reoperation rates were 19% after repair and 9% after conservative management. According to findings, both operative and nonoperative management in the patient group of MCL tears showed clinical improvements between study enrollment and 2-year follow-up. Patients with worse enrollment symptoms were assigned MCL surgery during ACL reconstruction and were associated with worse outcomes at 2 years of age. Operative management may benefit a subset of patients with severe combined ACL and medial knee injuries, however, this population has yet to be defined.