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Medial Collateral Ligament Tear

Medial Collateral Ligament or MCL is a band of tissues on the inner aspect of the knee. It runs from the thighbone to about six cms below the knee joint to the shinbone. Sportsmen playing soccer, hockey, and basketball or skiing are more likely to suffer from Medial Collateral Ligament (MCL) Tear. Also MCL tear can result from motor vehicle accidents. If the hit is on the outer aspect of the knee, it stretches the MCL more than normal, resulting in tearing of the MCL. MCL is the most important stabilizer of the knee, crucial for normal knee function.

Medial Collateral Ligament (MCL) of the knee joint

Depending on the intensity of the injury MCL tear has been categorized into three grades:

  • Grade I – this is the least severe injury to MCL. The ligament gets stretched, but is not torn in this case.
  • Grade II – In this case, the ligament is partially torn, causing some instability to the knee.
  • Grade III – This is the most severe form of MCL tear, where the ligament is completely torn.

Symptoms of MCL Tear:

Quite similar to the symptoms of any other knee injury there may be one or more of the following symptoms.

  • Swelling and pain in the inner part of the knee joint.
  • Knee Instability (a feeling of giving way) is mainly associated with Grade II and Grade III types of MCL tear.
  • Additional symptoms may be present depending on injuries to associated ligament structures.

MCL Tear leading to instability of the knee.

Diagnose of MCL Tear:

The doctor puts stress on the knee to know the actual ligament which is torn. Once the clinical diagnosis is arrived, an X-Ray is asked for to know the status of the bones of the knee. MRI scan helps to know the extent of the MCL tear, and the condition of the other ligament structures. It is not uncommon to see associated meniscal injuries in cases of MCL tear.

Treatment of MCL Tear:

As immediate treatment involves restriction of activity, followed by:

  • Applying ice to reduce swelling
  • Keeping the knee in an elevated position which also helps in reducing swelling.
  • Taking medicine to ease pain and swelling.
  • Compressing the knee using an elastic crepe bandage.
  • Complete rest which helps in faster healing of tissues.
  • Using crutches while walking to reduce the load on the injured knee.

MRI scan showing MCL tear

MCL Reconstruction surgery done using patients own ligament tissue as graft.

Hardly does an isolated MCL injury treatment require surgery, until and unless the injury is very complex and associated with other ligament injuries. Most of the times the treatment would include immobilisation of the knee in a plaster cast for 3 to 6 weeks. In complex injuries where additional ligaments are also injured surgery may be required. In generally pleasing results can be expected after treatment of MCL tears.

Authored By Dr. Raj Kanna - Orthopaedic and Knee surgeon, Chennai

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