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MEDIAL COLLATERAL LIGAMENT INJURIES

The medial collateral ligament is the primary and major stabilizer of the medial (inner edge) of the knee joint. It originates at a central point on the medial femoral condyle (upper bone) and widens out to attach to the proximal tibia (lower bone).

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An excess valgus force in which the knee drifts towards the opposite knee and the foot in the opposite direction will produce an injury to the MCL. Depending on the severity of the injury, the medial collateral ligament sustain

Classification Definition
Grade I A strain of the ligament. Tenderness, no instability
Grade II Broad tenderness, partially torn medial knee structures
Grade III Complete medial collateral knee ligament disruption

 

The patella dislocates laterally tearing the MPFL. A chondral injury to the cartilage lining of the patella can occur simultaneously.

The majority of medial collateral ligament tears can be treated conservatively; in other words without surgical intervention. This treatment can range from simple physiotherapy, painkillers and rest to the addition of various braces to protect ligament while it heals.

In a Grade III or complete disruption of the medial collateral ligament, surgery can sometimes be necessary if it is in conjunction with other significant injuries. In this setting, the medial collateral ligament can either be repaired if the injury is treated very early or reconstructed. Reconstruction involves the use of graft tissue to reconstruct and reinforce the medial collateral ligaments. I perform this procedure through small incisions on the medial or inner side of the knee.

The graft is typically hamstring graft harvested from the patient. Other options include allograft (tissue donor graft). These will be either tibialis tendons, Achilles tendons, or quadriceps tendons.

Rehab
In a medial collateral ligament tear which does not need surgery, the return to the sport is very much determined by the grade of the injury. This can range between 2 and 12 weeks.
If surgical reconstruction is required, then the return to sport is between 3 and 9 months.
Physiotherapy decreases the swelling and inflammation, regains motion and maintains muscle activation.
The final phase of recovery is guided by a Biokineticist, to regain balance, power and control

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