MCL tear - # clinic

Question 1

Most common injured ligament in knee

Hint hint

Answer 1

MCL (+ACL too)

Remember you saw it in # clinic

Question 2

MOI for MCL tear

Answer 2

• External rotational forces applied to lateral knee eg impact outside knee
• Usually acts as valgus stabiliser

Question 3

MCL grades of injury

Answer 3

• 1 - mild injury, minimally torn fibres, no loss of MCL integrity
• 2 - moderate injury, incomplete tear and increased laxity, only lax in 30 degrees flexion
• 3 - severe injury, complete tear and gross laxity, lax in 30 degrees and full extension

Question 4

Non contact MCL injuries MOI

Answer 4

• Valgus stress with external rotation eg skiiing

Question 5

Presentation MCL tear

Answer 5

• Audible pop
• Immediate medial joint line pain
• Swelling following a few hours (unless associated haemoarthrosis = occurs in minutes)
• Increase laxity when testing MCL via valgus stress test
• Tender along medial joint line
• May be able to weight bear

Question 6

Investigations MCL tear

Answer 6

• All patients with significant knee pain and swelling should have x-ray to exclude #
• MRI scanning - extent and grade

Question 7

Management MCL tear

Answer 7

• Grade 1 - RICE with analgesia (NSAIDs), strength training, return to exercise within 6 weeks
• Grade 2 - analgesia with knee brace and weight bearing exercise as tolerate, full exercise within 10 weeks
• Grade 3 - analgesia with brace and crutches, any associated distal avulsion - surgery considered. Return to exercise within 12 weeks

Question 8

Complications of MCL tear

Answer 8

• Instability of knee joint
• Damage to saphenous nerve