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November 21, 2008  
EDUCATION CENTER: Knee Conditions
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  • LCL Injury

    Description

    Reviewed by Dr. Peter Simonian

    A ligament is a tissue anywhere in the body that connects one bone to another. Within the knee, four ligaments stabilize the joint: the Posterior Cruciate Ligament, Anterior Cruciate Ligament, the Medial Collateral Ligament, and the Lateral Collateral Ligament, or LCL. This report details what occurs when your LCL tears, either completely or partially. An injury to the LCL or any other ligament is known as a "sprain," or, more commonly, a "tear" when it is most severe. Should the ligament separate from its attachment to the bone, it is known as an "avulsion."

    The LCL runs from the outside (lateral) portion of the femur (thighbone) to the lateral side of the tibia (shinbone). The durable ligament prevents the lower leg from moving medially, or toward the inside. A sprain to the ligament, most often brought on by a blow directly to the lower leg, can happen in one of three "grades":

    • Grade 1, in which the ligament is stretched, but not torn.
    • Grade 2, where the LCL is partially torn.
    • Grade 3, in which the LCL is completely torn and instability, or looseness of the joint, occurs.

    Depending upon the level of activity of the individual, an orthopedic surgeon may decide to operate or pursue conservative methods to manage the LCL tear. Depending upon the severity of the blow, an LCL tear may be accompanied by a fractured tibia or femur.

    Symptoms

    Suggestive of an LCL injury are:
    • Blow to the inside of the knee or fall to the side while foot is firmly planted.
    • Knee giving way or instability of the knee to the inside
    • Pain in the knee
    • Loss of sensation in the foot or below the knee, as the peroneal nerve passes alongside the LCL and may be disrupted at the time of injury or due to swelling in the area.

    Cause and Risk Factors

    Causes

    • A blow to the inside of the knee while the foot is planted
    • "Cutting" motion, or quick direction change
    • An LCL injury may be accompanied by a tear of the ACL or PCL

    Risk Factors

    Activities that can put you at risk for an LCL injury include impact sports such as skiing and other sports like football, basketball, soccer and other contact and non-contact sports. Also, previous LCL injuries or other serious knee injuries, or high degrees of joint laxity (looseness of ligaments) can be considered as risk factors for LCL damage.

    Treatment

    Immediate Action

    • Call your doctor. An LCL sprain is a serious injury that may require surgery.
    • RICE: Rest, Ice, Compression, and Elevation, is the best thing for most injuries for the first 2-3 days.
    • An ace bandage may provide comfort and prevent swelling.
    • Use crutches, if necessary.

    See your doctor If…

  • Your knee is weak or wobbly
  • The pain is too much to bear
  • You sprain your knee more than once
  • You have knee pain, swelling or stiffness that lasts more than a few days
    Procedures
    If a doctor suspects an LCL tear, he or she will likely order an MRI and X-Rays. The doctor will also give a thorough knee examination to determine the laxity (looseness), strength, and pain points within the joint. Most LCL injuries are treated conservatively with bracing and rehabilitation. However, some surgical methods exist to repair or reconstruct the torn ligament, as well as associated tears to the smooth cartilage surfaces within the knee.

    Prevention

    Steps you can take to try to prevent LCL injury, as well as other knee injuries, include proper stretching before and after exercise and using safety equipment when appropriate. Avoiding activities that put sideways strain upon your knee will also help you avoid an LCL injury. Building up the muscles in the thigh, the quadriceps and hamstring also help to stabilize the knee and can help in decreasing your risk of injury. Wearing a stabilizing brace may also help prevent injury.

    Last updated: 26-Oct-01

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