Fig 5.

Medial collateral ligament (MCL) graft fixation on the tibia: An intraoperative image of a right knee is shown, with the orientation as labeled in the figure. After the MCL graft is fixed on the femur, the broader end of the graft is passed underneath layer one of the knee (white solid arrow) with a passing suture. A 4.5-mm solid cortical screw with a spiked PEEK washer (Synthes, Westchester, PA) is used to secure the tibial end of the graft (white dotted arrow) while the knee is at 30° of flexion with a varus force applied.