Abstract
Medial collateral ligament (MCL) insufficiency during or after total knee arthroplasty (TKA) is a challenging scenario that often necessitates constrained implants or allograft reconstruction. This series describes 3 patients who underwent MCL repair with internal suture brace augmentation (ISBA). Two patients (ages 54 and 51) had chronic valgus instability after primary TKA and were treated with revision surgery using a more constrained implant or liner plus ISBA. A third patient (age 77) sustained an intraoperative MCL disruption during primary TKA and was managed acutely with ISBA. At 12-34.5 months of follow-up, all patients achieved full motion and medial stability. ISBA provided soft-tissue reinforcement and may represent a useful adjunct for medial instability, though its long-term effectiveness remains uncertain.