MCL Tear

MCL Tear

1. Most commonly injured ligament of knee

2. Primary function - valgus stabiliser

   • Most often injured when external rotational forces applied to lateral knee - impact to outside of the knee

3. DD

   • Fractures, meniscal injury, collateral ligament tears

4. Grades

   • Grade I – mild injury, minimally torn fibres, no loss of MCL integrity
     • Grade II – moderate injury, incomplete tear, increased laxity of MCL
       • Grade III – severe injury, complete tear, gross laxity of MCL

5. CFs

   • Typically after trauma to lateral aspect of knee
   • May hear ‘pop’ with immediate medial joint line pain & tender
   • Examination - increased laxity via valgus stress test
     • Grade II and III tear distinguished - Grade II is lax in 30 degrees , Grade III - lax in both positions
   • May be able to weight bear

6. Management

   • Grade I Injury - RICE, analgesia
     • Strength training incorporated, aim to return to full exercise within ~ 6 wks
     • Grade II Injury - Analgesia with knee brace
       • Weight-bearing/ strength training > Aim ~10 wks
       • Grade III Injury - Analgesia with knee brace & crutches
         • Aim ~12 wks

7. Complications

   • Instability in joint & damage to saphenous nerve

8. Ivx

   • Plain film radiograph - exclude fracture
   • MRI knee - gold