Conditions and treatments
Medial Collateral Ligament
The medial collateral ligament (MCL) is the most commonly damaged ligament of the knee joint. It is part of a complex structure called the medial soft tissue of the knee, being responsible for the stability of the knee when the joint is forced inwards by a lateral impact on the knee or while rotating and flexing with the foot on the ground.
What causes an MCL injury?
Most commonly, a MCL tears when an excessive force hits the lateral face of the knee, causing it to move inwards suddenly, or when the foot is caught and the knee is knocked from the outside.
What are the symptoms and how to diagnose?
Many people hear a “pop” or a “snap” and feel the knee giving way. This is followed by intense pain in the inside of the knee, difficulty in weight-bearing, and some people feel the knee is wobbly. Over time, the symptoms subside, but the giving way sensation may persist depending on how extensive the injury is, particularly while rotating the foot sideways or quickly changing directions. In time, localised pain and instability may persist. Diagnosis of a MCL tear is made by a physician through careful medical examination, where symptoms are interpreted, and a systematic gait and joint analysis is performed. When an injury is suspected, a MRI scan may identify the tear, as well as assess other joint structures.
How is it treated?
Fortunately the majority of MCL injuries heal very well without the need of a surgical procedure when they occur in isolation. Depending on the degree of instability and associated injuries, the use of an hinge brace to prevent excessive sideways movement may be needed from 4 to 6 weeks. Movement and weight-bearing as tolerated is usually allowed. In rare cases where chronic pain or residual instability occurs, in the setting of a multi-ligament injury, or some specific patterns of the MCL injury, surgery may be needed. The procedure may be repairing the torn tissue or reconstructing the ligament with a tendon that will replace the damaged structure. In either way, what follows is a staged individualised rehabilitation programme that will be explained to you, and closely monitored.
