What is treatment for mcl scarring after conservative treatment has not worked? constant pain going on two years

Discuss w ortho: Usually the first step is to obtain a better idea of the source of pain with diagnostic imaging or arthroscopy. Imaging is generally preferred so that non surgical corrections be implemented followed by planned surgical procedures.

Knee specialist: From your description including the pain, grinding, knee buckling etc it would imply that you also have atleast meniscal issues if not cartilage/joint issues. If the joint is unstable ta times then the ligament is not functioning properly. You may need an arthroscopic cleanout and confirmation of diagnosis followed by definitive treatment including ligament reconstruction. See your knee specialist.

MCL injury: Surgery unlikely if only an isolated mcl issue. Get MRI and orthopedic eval to check for other issues such as meniscus, loose body, acl, pcl.