The medial collateral ligament, or MCL, is a ligament on the inside of the knee that helps resist side-to-side movement of the knee. The MCL connects the femur, or thigh bone, to the tibia, or shin bone. Injury to the MCL is one of the most common injuries in young athletes who participate in ice hockey, skiing and football.
Symptoms
The symptoms of an MCL tear or sprain are pain and swelling over the MCL and the inner side of the knee. Patients often complain of the knee feeling unstable.
Causes
MCL injuries can occur with a rotation of the knee or by a trauma to the outside of the knee. A "pop" may indicate tearing of the ligament. A common method for injury is a football tackle in which the knee buckles as an opposing player hits the outside of the knee.
Complications
MCL injuries can occur in isolation or in conjunction with other ligament and meniscal injuries. Multiple injuries within the knee require different treatments and may carry a worse overall prognosis for return of complete function.
Diagnosis
A physician will perform a variety of physical examination tests. According to Dr. Phinit Phisitkul of the University of Iowa, the optimal time for evaluation of the knee is immediately after the injury. The physician may touch the inside of the knee to feel the MCL and assess swelling and deformity. Various maneuvers can be performed to stress the ligaments of the knee. The MCL is stressed when the knee is put into a "knock-knee" position. A physician may order an X-ray or an MRI to further evaluate to injury and the other structures of the knee.
Treatment
Treatment for MCL pain is usually nonoperative, with rest, anti-inflammatory medication, ice, elevation and physical therapy. If an MCL injury doesn't heal properly and the patient has chronic instability in the knee, surgery may be necessary to repair the MCL ligament.
References
- Australian Family Physician: Sports Knee Injuries
- "AAOS Comprehensive Orthopaedic Review"; Dr. Jay Lieberman, editor; 2008
- "The Sports Medicine Patient Advisor"; Dr. Pierre Rouzier; 2004.
- Iowa Orthopaedic Journal: MCL Injuries of the Knee
