In the athletic population, isolated anterior cruciate ligament (ACL) injuries, isolated medial collateral ligament (MCL) injuries, and combined ACL/MCL injuries are commonly seen. The recommended treatment of each of these injuries is different. Often, in the acute setting, the ACL is reconstructed and the MCL is managed nonsurgically. However, the management of patients with chronic combined ACL/MCL injuries is not as straightforward. If patients are treated with ACL reconstructions alone, some will have persistent medial laxity that may compromise their ACL reconstruction. The current surgical options that address laxity on the medial side of the knee require significant surgical exposure and mobilization of the tissues. Alternatively, the MCL healing response technique—microperforation—reestablishes an acute biologic healing environment for the chronically injured MCL.