Colorado Orthopedic News

Lateral Collateral Ligament Tear

Lateral Collateral Ligament Tear

Consider how important the simple movement of just walking is, then imagine how disabling a lateral collateral ligament tear can be if it causes knee pain or causes your knee to give way. Your lateral collateral ligament (LCL) is a thin band of tissue running along the outside of the knee that helps keep it stable. If left untreated, an LCL tear may be prone to further injuries over time. That’s why it’s important to visit the orthopedic specialists at Advanced Orthopedics & Sports Medicine Specialists in Denver, Parker, or Aurora, Colorado, as soon as possible before the injury takes a toll on the surrounding tissues.

OVERVIEW

The lateral collateral ligament is one of the more commonly injured ligaments in the knee. In the United States, 25% of the patients who present to the emergency room with acute knee pain have a collateral ligament injury. Adults aged between 20-34 and 55-65 years old have been shown to have the highest incidence. An LCL tear tends to happen more often in men and boys than women and girls. 40% of LCL tears occur in sports. The risk of having one is higher if there has been a previous LCL tear, and it is possible to tear the same lateral collateral ligament again.

ABOUT THE KNEE

The knee is the joint that connects the thigh to the lower leg. It’s the biggest joint in the body. Like all joints, the knees are part of the skeletal system. The knees also contain cartilage, muscles, ligaments, and nerves. The knees help support one’s weight and let the legs bend and move. Almost any movement that uses the legs relies on the knees — the knees help when walking, running, and jumping. Three bones make up the knee joint—the thighbone (femur), the kneecap (patella), and the shinbone (tibia). Ligaments are thick, strong bands of tissue that hold the bones together. Collateral ligaments are on the side of the knee.

WHAT IS A LATERAL COLLATERAL LIGAMENT TEAR?

An LCL tear is a strain or tear to the lateral collateral ligament. These knee injuries are categorized into three grades:

  • Grade I: This is an incomplete tear of the LCL. The tendon is still in continuity, and the symptoms are usually minimal. Patients usually complain of pain with pressure on the LCL and may be able to return to their sport very quickly. Most athletes miss one to two weeks of play.
  • Grade II: Grade II injuries are also considered incomplete tears of the LCL. These patients may complain of instability when attempting to cut or pivot. The pain and swelling are more significant, and usually, a period of three to four weeks of rest is necessary.
  • Grade III: A grade III injury is a complete tear of the LCL. Patients have significant pain and swelling and often have difficulty bending the knee. Instability, or giving out, is a common finding with grade III LCL tears. Grade III LCL tears commonly require surgical reconstruction.

CAUSES

The causes of an LCL tear injury include:

  • A direct blow to the inside of the knee. The force of the blow can impact the ligament along the outside edge of the knee enough to stretch it or make it tear. It’s common among athletes who play sports like football or hockey in which players collide with each other.
  • Changing directions quickly or pivoting on one foot. This can happen during fast-paced sports like soccer or basketball, where players make sharp, sudden turns or stops. Wrestlers can have LCL damage if their legs twist outward in a sudden movement when they’re on the mat.
  • Landing badly or awkwardly from a jump. This can happen during a basketball or volleyball game.

SYMPTOMS

Symptoms of a lateral collateral tear include:

  • Pain that can be mild or acute
  • Swelling
  • Tenderness
  • Stiffness
  • Bruising
  • An unstable feeling as if the knee is about to give out or buckle or lock up
  • A locking or catching in the joint when it is moved
  • Numbness or weakness in the foot may occur if the peroneal nerve, which is near the ligament, is stretched during the injury or is pressed by swelling in surrounding tissues

NON-SURGICAL TREATMENTS

Some things can be done at home to help an LCL injury heal, but treatment will depend on the grade of the injury.

Mild or grade I—Home care includes icing the knee, wrapping it in an elastic bandage, elevating the knee above heart level, staying off the leg (crutches may be needed until the injury heals), and taking nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen and naproxen (NSAIDS)

Moderate or grade II—It might be recommended to wear a lightweight cast, splint, or brace that allows the knee to move backward and forward but restricts side-to-side movement. This is usually worn for 72 hours. Depending on how well it reduces pain and swelling, a rehabilitative program could start in a few days.

WHEN IS SURGERY INDICATED?

The LCL does not heal as well on its own compared to other knee ligaments, such as the medial collateral ligament (MCL). When an LCL injury fails to heal adequately, or if the tear is severe, surgery to repair or reconstruct the LCL may be recommended. The ligament is often injured during significant trauma, such as a knee dislocation, which may require surgery. It is also common for LCL injuries to occur along with other ligament injuries, including ACL tears, PCL tears, and other damage within the knee. This increases the need for surgery. In certain cases, partial rupture of the LCL may be enough to warrant surgery, particularly in athletes. Within this context, those who undergo LCL repair tend to have better knee stability than those who opt for nonsurgical treatment.

GETTING THE RIGHT DIAGNOSIS. GETTING THE RIGHT DOCTOR.

The highly experienced knee doctors at Advanced Orthopedics in Denver, Parker, and Aurora, Colorado, have the expertise to diagnose and treat your lateral collateral ligament tear with various cutting-edge options. As one of the most well-regarded orthopedic groups in Colorado, they have spent thousands of hours treating LCL injuries such as yours. After thoroughly examining your knee to determine the extent of the injury and if there are other injuries, imaging tests such as X-rays, MRIs, and ultrasounds may be ordered. Other special tests that involve flexation, rotation, and forceful pressure on the knee can provide a positive indication of whether the injury is a lateral collateral ligament tear or something else. At Advanced Orthopedics, you can trust getting the best and most personal care that will get you moving and back in the game again. Schedule an appointment today with a knee specialists.

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