Medial Collateral Ligament Injury (MCL Injury) Overview
The medial collateral ligament (MCL) is a thick fibrous band of tissue that extends from the end of the femur to the top of the tibia and is located on the inside of the knee joint. The MCL is responsible for providing stability when the knee is moved from side to side. An MCL injury occurs when extreme force is applied to the outside of the knee joint. A common example is a football player is tackled with an impact to the lateral side of his knee (clipping injury). When the MCL is stressed beyond its normal range, a stretched or torn MCL may occur. Depending on the severity of the injury, other ligaments may be damaged as well. Dr. Brian Waterman, orthopedic knee specialist, is highly experienced in treating MCL injury symptoms and returning patients to an active, pain-free lifestyle.
An MCL injury is more common in athletes and active patients. Common activities that cause a torn MCL include a fall, a hard hit or an awkward landing during sports activities, or direct impact during contact sports such as football. Injuries to the MCL are classified in a grade 1 to grade 3 range according to the severity of the injury. A grade 1 injury represents a strain of the ligament which is painful but the ligament remains intact. A grade 2 injury represents a more significant partial tear, commonly accompanied by knee instability. A grade 3 injury represents a complete tear of the ligament with significant instability.
MCL Injury Symptoms
The main MCL injury symptoms include localized pain and swelling. Depending on the injury severity, bruising and instability may be present. Some patients may experience a feeling that the injured knee may give way under stress or may lock or catch.
MCL Injury Diagnosis
MCL injury symptoms are examined by Dr. Waterman through a physical examination, X-rays and an MRI. The physical examination will test range of motion, strength, function and pain level. X-rays will rule out any bony injuries to the joint. An MRI may be used to assess the ligament and other knee structures in more detail.
MCL Injury Treatment
Non-surgical treatment is commonly recommended by Dr.Waterman for a grade 1 or grade 2 torn MCL. A grade 3 MCL tear typically requires a surgical intervention to return the ligament to its proper function.
A partially torn MCL with limited knee instability may be effectively treated with a combination of rest, ice, heat, physical therapy and bracing. If the MCL is stretched or partially torn, then conservative treatment usually corrects the ligament allowing functional recovery and a return to all activities in 6-8 weeks.
A complete tear of the MCL may require a surgical approach to repair or reconstruct the ligament and alleviate MCL injury symptoms. If surgery is needed, Dr. Waterman may recommend an open procedure to repair or reconstruct the ligament. If possible, he will suture the torn MCL and perform a repair in order to promote healing. If this is not possible, he will perform either an augmentation (suturing the remaining ligament and reinforcing with a graft) or a complete reconstruction (reconstructing the entire ligament with a graft) depending on the degree of injury. The grafts are typically taken from the patient or are a donated graft from another individual.
In addition, high grade MCL injuries are commonly associated with other ligament injuries within the joint such as ACL or PCL tears. In this situation, the other ligaments are repaired or reconstructed at the time of surgery.