Lateral collateral ligament injury

Lateral collateral ligament injury: Description, Causes and Risk Factors:Ligaments are like strong ropes that help to connect bones together and provide stability to joints. The lateral collateral ligament (LCL) connects the femur to the fibula (the smaller bone which runs parallel to the tibia), and stabilizes the outer side of the knee joint.Lateral collateral ligament injuryThe Lateral collateral ligament injury is most commonly injured in Sports by a direct impact to the inner surface of the knee joint, such as by Rugby or a football tackle.
  • An Lateral collateral ligament injury injury may also be caused by a direct blow to the anteromedial aspect of the knee or a non-contact varus or hyperextension injury.
  • An Lateral collateral ligament injury injury may also occur concomitantly with other ligamentous injuries in the setting of a multiple ligamentous knee injury as a result of a significant trauma, such as a motor vehicle accident or fall from height.
Injuries of this type are less common than those affecting the medial collateral ligament (MCL) which commonly occurs as a result of trauma to the outer surface of the knee joint. In addition, the Lateral collateral ligament injury is not connected to the lateral meniscus and so unlike MCL injuries, they are not normally associated with meniscal tears. However, due to the nature of the injury the anterior cruciate or posterior cruciate ligaments may also become damaged.Grades:Grade 1 - Interstitial injury without laxity is present, but pain occurs varus stress; only microscopic tearing has occurred.
  • Grade 2 - A 5-10 mm of joint-space opening with a distinct end point is noted; partial macroscopic tearing has occurred.
  • Grade 3 - Complete tearing (>10 mm joint-space opening) has occurred; complete macroscopic tearing is noted.
Symptoms:Symptoms include pain, difficulty on uneven ground, swelling, and ecchymosis. Patients may also describe paresthesias as well as a foot drop if injury to the peroneal nerve.Diagnosis:The initial aim of a Sports Medicine specialist is to take complete history including age, occupation, Recreational activities, Lifestyle &interests. Previous knee symptoms, injuries, or surgeries should also be elicited.Radiography of the knee should always be the initial imaging modality. Three views of the knee consisting of anteroposterior (weight-bearing if patient is able to tolerate), lateral, and Merchant views are obtained. Findings include varus mal-alignment when standing, dislocation, subluxation, fracture, quadriceps tendon disruption, patellar tendon disruption, and arthritis.MRI is an important diagnostic tool for evaluating the Lateral collateral ligament injury as well as the structures of the posterolateral corner. Cartilage, cruciates, and menisci can also be evaluated with an MRI study.In cases of suspected multi-ligamentous knee injury or knee dislocation, an arteriogram may be necessary to rule out suspected arterial injury.Treatment:Depending on the severity of the injury a number of treatment options are presented to the clinician. In grade 1 & 2 tears, conservative methods of treatment are usually preferred. These may need to be carried out for up to 8 weeks and may include:Prescription of NSAID's (e.g. Ibuprofen).
  • Use of manual techniques such as massage.
  • Advise on a full rehabilitation program, which may include strengthening and proprioceptive (balance) exercises.
  • Laser treatment.
In grade 3 sprains (ruptures), particularly when other structures such as the ACL or PCL are damaged, surgery may be needed to prevent future instability. This may involve suturing (stitching) the torn ends of the Lateral collateral ligament injury or re-constructing the ligament with a part of a tendon e.g. hamstrings tendon. Recovery from these injuries is a lot slower than conservative methods and it may be a number of months before the athlete is able to return to Sports.NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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