Medial Collateral Ligament
The medial or tibial collateral ligament (MCL) is a structure located on the inside of the knee. It stabilizes the joint by preventing the knee joint from opening when lever movements are performed. MCL injuries are common, especially among professional or recreational athletes.
Anatomy of the Medial Collateral Ligament
The medial collateral ligament is located on the inner side of the knee and is the largest structure in the area, measuring 8 to 10 centimeters in length. It is inserted into a small bony prominence of the femur, known as the medial femoral epicondyle, and extends to the tibia, inserting itself 5 to 7 cm below the articular surface of the knee.
How the Injury Occurs
Injuries to this ligament are usually caused by a lateral movement of the leg and foot in relation to the knee with the joint partially bent, such as a lever movement. When an associated rotational movement is performed, injuries to other knee ligaments can also occur.
What a Person Feels When the Injury Occurs
After injury to the medial collateral ligament, patients often experience pain in the inner region of the knee. There may be an effusion of the joint and even instability in the inner region, such as a sensation of buckling. There may also be a hematoma at the site of the injury.
Necessary Exams
Some imaging exams can help the doctor when there is a suspicion of a rupture of the medial collateral ligament, such as X-rays and magnetic resonance imaging. These exams allow a more detailed evaluation of other structures that may be injured during the twist, such as cartilage, menisci, other ligaments, among others. Tibial collateral ligament injuries are divided into three grades, according to severity. When there is only a stretching of the fibers, without ligament rupture, we consider the injury to be grade I. When the ligament fibers partially tear it is grade II. And when the patient completely ruptures the ligament, it is grade III.
Treatment
In most cases, treatment of the medial collateral ligament injuries does not require surgical intervention. Unlike the anterior cruciate ligament, the MCL has a great potential for healing. Immobilization with a Velcro device (orthosis) or plaster splint for a few days or even a few weeks is usually enough to obtain excellent results. In the first few days following the injury, the use of analgesic and anti-inflammatory medications can help.
In specific situations, such as those in which the patient remains with residual instability of the knee even after the treatment with immobilization, surgery may be necessary to improve the condition.
Rehabilitation with Physiotherapy
Patient's rehabilitation with physiotherapy plays a fundamental role in obtaining a convincing outcome. The treatment is carried out in order to reduce pain and inflammation and gradually gain range of motion of the knee, improve balance and restore muscle strength of the affected limb.
