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Medial Collateral Ligament (MCL) Injury
Medial Collateral Ligament (MCL)
The knee joint has 2 collateral ligaments; the medial collateral ligament - MCL (inside part of knee) and the lateral collateral ligament - LCL (outside part of knee). The MCL is actually fairly complex in its structure and attachments, connecting the femur (thigh bone) to the tibia (shin bone) preventing excessive side to side translation of these 2 bones. It also has very important attachments to the meniscus or cartilage cushion inside the knee on the medial side (inside part). This helps to stabilize the meniscus and prevent it from moving more than it should. It also has a very small role in rotational stability of the knee and anterior to posterior (forward to backward) translation of the lower leg.
A tear in the MCL occurs as a relatively common injury in certain sports such as football, soccer and basketball as it typically results from another player falling on, or striking the outside of the knee joint. This applies a "valgus" force to the knee which describes the situation where the knee assumes a more "knock-kneed" position rapidly. This applies a significant stretch to this ligament and can lead to partial or complete tears. This has become a relatively common mechanism of injury, especially in collegiate football linemen, so much in-fact that many college programs require their linemen to wear special knee braces to help prevent this injury as the pile of players fall on one another routinely at the line of scrimmage. There is actually a small amount of scientific evidence to support this idea.
Typically with an injury to the MCL, the player will experience pain and possibly a "pop" on the medial or inside part of the knee. There may be a small amount of swelling and eventually bruising in this area, but typically the swelling is not dramatic and does not involve the entire knee. The bruising pattern can also demonstrate the specific area of the injury and sometime the mechanism as well. The player will have pain, however this may resolve nearly 100% even within a few days for minor injuries and low grade partial tears. With larger and more severe injuries, the pain may persist and the player may experience a sense of instability or shifting of the bones while walking or attempting to return to play.
The diagnosis is made based on the history of the injury (how it happened) and the symptoms that are present at the time of evaluation, as well as some specific physical exam tests that your orthopaedic surgeon will perform. This is typically how the extent and grade of the injury is determined. X-rays and an MRI are important to obtain as well to identify, in detail, the location of the injury within the ligament and any associated injuries. The injury location is a key piece of information as it will affect the prognosis for healing without surgery.
Most injuries to the MCL can be treated conservatively, or without surgery. It does however require a certain amount of bracing to protect the ligament and allow the body to heal it. Typically the body is capable of this and players can return to play without restrictions, but the time at which this occurs is variable depending on the extent of the injury. If surgery is required, there is a chance to directly repair the ligament in some cases. If this is not possible, due to either the location or extent of the injury, or if it is a chronic injury, then a graft reconstruction (replacement with other tissue) is used.
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Medial Collateral Ligament (MCL) Injury
Medial collateral ligament (MCL) injury is a strain or tear to the inside of the knee joint ligament.
Medial Collateral Ligament Injury
MCL-tear