Medial collateral ligament tear

Question 1

what is the role of the MCL?

Answer 1

valgus stabiliser of the knee

Question 2

what is important about MCL tears?

Answer 2

the MCL is the most commonly damaged ligament of the knee

Question 3

how MCL injuries graded?

Answer 3

Grade I: mild injury with minimally torn fibres - no loss of MCL integrity
Grade II: moderate injury with incomplete tear and increased laxity of MCL
Grade III: severe injury with complete tear and gross laxity of MCL

Question 4

what are the clinical features associated with MCL tears?

Answer 4

Hx of trauma to the lateral aspect of the knee #
pop with immediate medial joint line pain
swelling develops after a few hours

examination:
increased laxity on valgus stress test
tender on medial aspect

Question 5

what investigations are performed in suspected MCL tears?

Answer 5

X-ray to rule out fractures

MRI - extent and grade of tear

Question 6

what is the management of MCL tears?

Answer 6

dependant on the grade :

• Grade I: RICE with analgesia (NSAIDS). strenth training and return to full exercise in 6 weeks
• Grade II: analgesia with knee brace and weight bearing/strength training. return to full exercise in 10 weeks
• Grade III: analgesia with knee brace and crutches. return to full exercise in 12 weeks