Ligament Tear/Sprain (ACL/MCL/LCL/PCL)
There are 4 ligaments that help stabilize the knee. There are 2 cruciate ligaments, the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) as well as 2 collateral ligaments known as the medial collateral ligament (MCL) and lateral collateral ligament (LCL). These ligaments connect the thigh bone to the leg bone. Injuries to these ligaments are most commonly seen in people who play contact sports such as football and soccer.
The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) as well as the medial collateral ligament (MCL) and lateral collateral ligament (LCL) help in stabilizing the knee. The ACL and PCL are inside the knee. The MCL is on the medial aspect of the knee and the LCL is located on the lateral or outside of the knee.
When an injury occurs to the MCL or LCL this causes the knee to become unstable. Pivoting and twisting will cause the knee to give out or give way. Injuries to the ACL or PCL will also cause complaints of instability to the individual.
Injuries to the collateral ligaments either the MCL or LCL normally occur from a direct blow on the inside of the knee or outside of the knee.
When an individual has an injury to the MCL or LCL they get a sensation as if the knee is giving out or giving way with the knee either hinging open on the inside of the knee or hinging open on the outside of the knee. These injuries are commonly associated with swelling and pain.
Your orthopedic surgeon will evaluate the knee for full range of motion and strengthening as well as assess for any laxity to the inside of the knee or MCL and outside of the knee or LCL.
X-rays:X-rays will be performed in the office to assess for any abnormality to the bone or a fracture. In some instances a piece of bone will be avulsed off when a ligament tear occurs.
MRI: MRI will normally be performed to assess for medial or lateral collateral ligament injuries, since MRIs show soft tissue better than x-rays.
Medial collateral ligament (MCL) injuries are usually treated nonoperatively. If the injury occurs on the femoral or thigh attachment the overwhelming majority of these are treated with icing, nonsteroidal antiinflammatories (NSAIDs) and a hinged knee brace. These will normally heal between 2-4 weeks depending on severity of the medial collateral ligament injury.
Injuries at the tibial attachment depending on severity may require a surgical repair or reconstruction. After bracing for the MCL injury or surgical repair of the MCL injury, physical therapy is usually started. Physical therapy is comprised of range of motion and strengthening to allow the athlete or person to return back to activities without restriction.
Lateral collateral ligament (LCL) injuries if minor, are treated conservatively with a hinged knee brace. Icing and nonsteroidal antiinflammatories (NSAIDs) are used as well to decrease swelling and inflammation. Complete tears of the LCL are usually reconstructed with an allograft. After the LCL is healed, whether it was treated conservatively with bracing, antiinflammatories and icing or LCL reconstruction, physical therapy is commenced. Physical therapy is comprised of range of motion and strengthening in order to allow the patient to return back to all activities without restriction.
Questions you may have asked.
- Did I tear my ACL?
- Why is my knee swollen?
- Why is my knee unstable?
- Did I tear a ligament in my knee?