Medial Collateral Ligament Injury of the Knee

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Original Editors - Sem Bras

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Search Strategy[edit | edit source]

  •  Database : PEDro
  1. Medial collateral ligament
  2. MCL
  3. Medial collateral ligament AND injury
  4. MCL AND injury
  5. Medial collateral ligament AND lesion
  6. MCL AND lesion
  • Database : Pubmed
  1. MCL
  2. MCL AND RCT
  3. Medial Collateral ligament AND injury
  4. MCL AND injury
  • Database : GoogleSCHOLAR
  1. Medial Collateral ligament AND lesion
  2. MCL AND lesion
  3. Medial Collateral ligament AND injury
  4. MCL AND injury

Definition/Description[edit | edit source]

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Clinically Relevant Anatomy [edit | edit source]

A ligament, made of tough fibrous material, functions to control excessive motion by limiting the joint mobility. The medial collateral ligament (MCL) is one of the four ligaments that are critical to maintain the stability of the knee joint. The four major ligaments of the knee-area are the cruciate ligaments ( anterior and posterior ), and the collateral ligaments (medial and lateral) . Important to know is that this ligament has two parts to it, respectively a deep inner section that attaches to the medial meniscus and joint margins, and a superficial section that attaches from higher up on the thigh bone to the inner surface of the shin bone. Its function is to resist forces applied from the outer surface of the knee and so prevent the medial portion of the joint from widening under stress.



 

Epidemiology /Etiology[edit | edit source]

 MCL injuries mostly occur after an impact on the outside of the knee. The MCL on the inside of the knee becomes stretched. When the force of the impact is big enough, some or all the fibres will tear. Mostly the deep part of the ligament gets damaged first, and this may lead to medial meniscal damage (more information about meniscal damage and meniscal repair is given in the article of my colleague-student, Céline Vankeerberghen) or anterior cruciate ligament damage (further information is given in the article of my colleague-student, Kevin Campion).

Characteristics/Clinical Presentation[edit | edit source]

As with all the ligament injuries, the MCL injury is graded 1, 2 or 3 (this grade is given depending on the degree of sustained) . A grade 1 tear consists of less than 10% of the collagen fibres being torn. Grade 2 tears vary in symptoms and therefore they are broken down further to grades 2- (closer to grade 1) and 2+ closer to grade 3). Obviously, this means that a grade 3 tear is a complete rupture of the MCL.
The symptoms for a grade 1 tear of the MCL are minimal. Patients complain about a mild tenderness on the inside of the knee. Usually we can’t detect a swelling over the ligament or joint laxity. Most of the patients feel pain when we apply force on the outside of a slightly bent knee.
Grade 2 injuries are also considered as incomplete tears of the MCL. Patients with a grade 2 tear mostly complain about instability when attempting to cut or pivot. The pain and swelling are more significant than with grade 1 injuries. When the knee is stressed (as for grade 1), patients complain about pain, moderate laxity in the joint and a significant tenderness on the inside of the knee.
When we speak of a grade 3 tear of the MCL, it is considered as a complete rupture of the ligament. Patients have significant pain and swelling over the MCL. Most of the time they have difficulty bending the knee. Another common finding of a grade 3 tear is instability. When we stress the knee (as described above) there is joint laxity.

Differential Diagnosis[edit | edit source]

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Diagnostic Procedures[edit | edit source]

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Outcome Measures[edit | edit source]

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Examination[edit | edit source]

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Medical Management
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Physical Therapy Management
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Key Research[edit | edit source]

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Resources
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Clinical Bottom Line[edit | edit source]

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Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

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