Medial Collateral Ligament (MCL) Tear/Sprain
Definition:
Located on the medial aspect of the knee and maintains stability by being a primary restraint to valgus rotation and lateral rotation with LCL (Dutton). Most common mechanism of injury is a direct blow to the lateral side of the knee with the foot planted, if the foot is not planted do not rule out other structure as the possible cause for symptoms.
Subjective:
Objective:
Intervention:
Pellegrini Steida Syndrome:
The ossification of the femoral attachment of the MCL of the knee with associated pain and restricted movements (Theivendran). This is a rare condition and mild cases are successful with conservative treatment (Theivendran). More significant bone formation and persistent symptoms require surgical excision (Theivendran).
Located on the medial aspect of the knee and maintains stability by being a primary restraint to valgus rotation and lateral rotation with LCL (Dutton). Most common mechanism of injury is a direct blow to the lateral side of the knee with the foot planted, if the foot is not planted do not rule out other structure as the possible cause for symptoms.
Subjective:
- Pain on the medial aspect of the knee typically at the origin (adductor tubercle)
- Pain at the joint line
- Stiffness
- Swelling
- Tenderness (MedlinePlus)
- The knee may feel unstable and may lock or catch (MedlinePlus)
Objective:
- Valgus stress full extension
- Most specific test is valgus stress test at 30 degrees flexion (Dutton).
- Painful gait may be noticed
- Knee extension and tibial external rotation will be uncomfortable.
Intervention:
- Pain management acutely
- RICE (rest, ice, compression, elevation)
- Maintain range of motion particularly flexion
- Strengthen muscles around the knee (UCSF).
Pellegrini Steida Syndrome:
The ossification of the femoral attachment of the MCL of the knee with associated pain and restricted movements (Theivendran). This is a rare condition and mild cases are successful with conservative treatment (Theivendran). More significant bone formation and persistent symptoms require surgical excision (Theivendran).
References:
- Dutton M. Orthopaedic Examination, Evaluation, and Intervention. 2nd ed: The McGraw-Hill Companies, Inc.; 2008.
- MedlinePlus. Medial Collateral Ligament (MCL) injury of the knee. National Health Institute. Accessed on 26 June 2012 http://www.nlm.nih.gov/medlineplus/ency/article/001076.htm
- UCSF. Orthopedics, PCL Tear Diagnosis. University of California San Francisco. Accessed 26 June 2012 http://www.ucsfhealth.org/conditions/mcl_tear/
- Theivendran K, Lever CJ, Hart WJ. Good result after surgical treatment of Pellegrini-Stieda syndrome. Knee Surg Sports Traumatol Arthrosc. Oct 2009;17(10):1231-1233.
- Image: http://www.drbraceco.com/understanding-your-knee.php