LCL Injury & Posterolateral Corner Injury Overview
The lateral collateral ligament (LCL) is the main structure on the outside (lateral) portion of the knee that prevents the knee from gapping open. The LCL is often referred to as the FCL, or fibular collateral ligament. The LCL, popliteofibular ligament (PFL) and the tendon of the popliteus muscle compose the Posterolateral Complex (PLC). These three structures work together to provide knee stability when the joint experiences side to side motion and rotational movements. An LCL injury may occur in isolation or a posterolateral corner injury may occur with damage to all three structures. Dr. Brian Waterman is well trained and highly experienced in treating LCL/PLC injuries.
An LCL injury can occur from a blow to the inside of the knee, a hyperextension injury or from a sudden stop and start. These can occur during sports activities or an automobile accident. If the impact is too severe, the ligament can become stretched or torn. The nearby ligaments and tendons can also experience injury.
Symptoms of an LCL Injury or Posterolateral Corner Injury
In most cases, patients will experience pain, tenderness and swelling at the time of injury. In some cases, an LCL injury can go undiagnosed for several weeks before a patient experiences knee stability from side to side movements. Symptoms of an LCL injury or a posterolateral corner injury may be seen with other knee injuries so it is important to seek medical care at the time of injury or the onset of symptoms.
Diagnosis of an LCL Injury or Posterolateral Corner Injury
An LCL/PLC injury is diagnosed by Dr. Waterman through a physical examination and diagnostic tests. Dr.Waterman will manipulate the affected knee into various positions to determine pain level, mobility and range of motion. X-rays will be performed to examine a possible injury to the bone and in certain cases a stress X-ray of both knees will be performed to compare stability. An MRI scan may be performed to determine the extent of damage to the LCL/PLC.
Treatment of an LCL Injury or Posterolateral Corner Injury
An LCL injury may be treated with non-surgical measures if a simple strain or sprain is diagnosed. The RICE method (rest, ice, compression and elevation), bracing, physical therapy and strengthening exercises prove to be beneficial in a non-severe posterolateral corner injury or LCL injury in many cases.
If non-surgical measures do not alleviate the symptoms or if an LCL injury is too severe, Dr.Waterman may recommend surgery. He will perform a lateral knee reconstruction, either arthroscopically or open surgery, to replace the damaged ligament with a graft. Most commonly, a donor tendon (allograft) is used to reconstruct and augment the torn structures. The graft is attached to the native anatomic insertion sites of the lateral structures most commonly using screws. All three structures involved in a posterolateral corner injury must be addressed and returned to their original anatomy. If other ligaments are injured, they will be repaired during the same procedure.