The medial collateral ligament (MCL) is one of the four major ligaments that are critical to knee stability . The ligament is made of a strong fibrous material and is designed to control excessive movement by limiting joint mobility. The four main stabilizing ligaments of the knee are the anterior and posterior cruciate ligaments ( ACL and PCL ) and the medial and lateral collateral ligaments (MCL and LCL ) .
The MCL spans the distance from the end of the femur (femur) to the apex of the tibia (tibia) and is located on the inside of the knee joint . The MCL prevents the inside of the joint from expanding, which can be seen as an impediment for the knee to open. If the MCL is completely torn, the injury will cause the joint to weaken another 2-5 degrees. If other surrounding soft tissues are damaged, the amount of laxity will roughly double. The MCL is not the only limitation of the excessive opening of the inner side of the knee, but also the main limitation of this movement.
Because the MCL resists expansion of the inside of the knee, the ligament is usually damaged when it is struck on the outside of the knee. This force causes the outside of the knee to bend and the inside to expand. When the MCL is overstretched, it is prone to breaking and injury. This is an injury that is seen as a result of a haircut at a soccer game.
The MCL injury can be isolated or be part of a complex knee injury. Other ligaments, most commonly the ACL or meniscus , can tear along with the MCL injury.
To prevent the possibility of tearing the MCL, some athletes wear braces to avoid excessive stress on the ligaments. They are the most used by American football players, especially linesmen. These athletes are often exposed to high lateral forces on the knee joint, a mechanism that can lead to an MCL injury. The usefulness of these braces is controversial, but there is probably a small advantage in terms of preventing the likelihood of injury when wearing a brace in such situations.
The most common symptom of an MCL injury is pain over the ligament. Swelling may appear over the torn ligament, and bruising and general swelling of the joints often appear 1 to 2 days after the injury. In more serious injuries, patients may complain of knee instability or a feeling that the knee is "giving out" or bending .
Symptoms of an MCL injury generally correlate with the extent of the injury. MCL injuries are generally graded on a scale from I to III.
- Grade I MCL tear: This is an incomplete MCL tear. The tendon remains continuous and symptoms are usually minimal. Patients often complain of pain when applying pressure to the MCL and can return to sports very quickly. Most athletes lose one to two weeks of play.
- Grade II MCL Tear: Grade II injuries are also considered incomplete MCL tears. These patients may complain of instability when attempting to cut or twist. Pain and swelling are more important. Usually a three to four week break is required.
- Grade III MCL tear: A grade III injury is a complete tear of the MCL. Patients experience severe pain and swelling and often have difficulty bending the knee. Instability or discharge is a common finding in grade III MCL tear. Typically, a knee brace or knee immobilizer is needed for comfort, and healing can take 10-12 weeks.
One of the abnormalities of the medial collateral ligament is the Pellegrini-Stied sign, which is often seen in chronic MCL injuries. This abnormality is visible on X-rays when calcium deposits are visible on the MCL. Typically, the calcium deposit is near the ligament attachment site to the end of the femur. People with pain in this area are sometimes said to have Pellegrini-Stied syndrome. Treatment for this condition is usually reduced to simple steps, although in rare cases calcium deposits can be removed.
Treatment for an MCL tear depends on the severity of the injury. Treatment always begins with pain relief and mobility work. After that, you need to strengthen your knees and go back to sports. Braces can often be helpful in treating MCL injuries. Fortunately, most of the time, surgery is not required to heal a ruptured MCL .