LCL/MCL/PLC Injuries & Surgery in Kirkland, WA
MCL Injuries & Surgery
What is the MCL?
The medial collateral ligament (MCL) is located on the inside of the knee. It is a strong flat band of fibrous tissue that extends from the medial epicondyle of the femur (thigh bone) to the medial plateau of the tibia (shin bone). The MCL prevents the inside of the knee from opening up or buckling during movement.
What are the causes and symptoms of MCL injuries?
The MCL is typically injured from a blow to the outside of the knee. An MCL tear can occur as an isolated injury or it can be associated with other knee injuries, in particular tears of the ACL and medial meniscus. The most common symptom following an MCL injury is pain directly over the ligament on the inside (medial side) of the knee. There is often also an initial limitation to motion. Symptoms of a medial collateral ligament (MCL) injury tend to correlate with the extent of the injury. The severity of the injury is graded from I (minor) to III (complete tear).
How are MCL tears treated?
Most MCL tears heal on their own, without the need for surgery. In higher-grade injuries, a brace is often prescribed to protect the ligament while it heals. Grade I and grade II injuries are usually resolved within 4-6 weeks, though full recovery may take longer. During this time, it is important to regain and maintain knee motion, while also working on strengthening the surrounding muscle groups.
Grade III injuries are more severe injuries that are often associated with tears of other ligaments in the knee. Surgical repair of the MCL may be needed for some grade III injuries, and occasionally for chronic MCL injuries that have not healed appropriately.
LCL / PLC Injuries & Surgery
What is the LCL and PLC?
The lateral collateral ligament (LCL) is located on the outside (lateral side) of the knee and connects the femur to the fibula. It is part of a larger group of complex structures referred to as the posterolateral corner (PLC). Other important structures in the posterolateral corner are the popliteus tendon, biceps femoris tendon, and the popliteofibular ligament. The LCL and PLC structures provide stability to the outside of the knee and are important for rotational stability as well.
What are the causes and symptoms of LCL and PLC injuries?
The LCL and PLC are typically injured from a blow to the inside of the knee or result in combination with tears of other knee ligaments (ACL, MCL, or PCL).
The most common symptom following an injury to the LCL and PLC is pain over the outside of the knee. Swelling, decreased motion, and instability are also common with this injury. It may also become difficult to place weight on the knee.
How are LCL and PLC tears treated?
Partial tears of the LCL and PLC structures can be treated without surgery, but complete tears usually require surgical treatment. The torn ligaments can sometimes be repaired (sewn back together) or are reconstructed using a tendon graft obtained from either the patient more often a cadaver (allograft). If other ligaments are also injured in the knee (ACL, MCL, or PCL), these can be surgically addressed at the same time.
PCL Injuries & Surgery
What is the PCL?
The PCL, along with the ACL, is located in the center of the knee. Its primary function is to prevent posterior translation of the tibia on the femur. The PCL also plays a role in the side-to-side stability of the knee.
What are the causes and symptoms of PCL injuries?
The PCL is injured less commonly than the ACL. The most common mechanism of injury involves a blow to the front of the tibia (shin bone) when the knee is bent. PCL tears can occur as isolated injuries or can be associated with other knee injuries.
The symptoms of a PCL injury are usually less dramatic than those of an ACL tear. Swelling is often only mild. The pain from a PCL injury is usually resolved within 2-4 weeks. However, a sense of instability may persist.
How are PCL injuries treated?
Treatment for isolated PCL injuries initially focuses on rehabilitation and strengthening after the pain and swelling subside. Partial tears of the PCL do not usually require surgical treatment; even isolated complete tears of the PCL do not always need surgical treatment.
If symptoms of instability persist after rehabilitation, surgical reconstruction of the PCL is recommended. Modern PCL surgery involves completely removing the torn ligament and reconstructing the torn PCL using a minimally invasive arthroscopic technique. The new PCL is made using a tendon graft, usually from a cadaver (allograft).