Medial (MCL) and Lateral (LCL) Collateral Ligament Tears: Treatment Options

Medial (MCL) and Lateral (LCL) Collateral Ligament Tears: Treatment Options

The collateral ligaments, which include the medial collateral ligament, or MCL, and the lateral collateral ligament, or LCL, are located outside of the knee joint. Tears to these ligaments can make the knee painful and unstable.

An MRI can be used to determine the extent of a collateral ligament tear, and grade it from 1 to 3. The grade of the tear, along with the patient's symptoms and quality of life, will help determine the best course of treatment. Fortunately, most cases of collateral ligament tears can be treated without surgery.

While MCL tears are more common than LCL tears, treatment for both types of injuries is similar. Grade 1 tears are mild, microscopic tears that can be managed with non-surgical treatment. Resting and limiting physical activity, bracing, and physical therapy to improve strength and range of motion can help while these tears heal.

Grade 2 tears are moderate, partial tears that disrupt some of the ligament's fibers. When these tears occur by themselves, nonsurgical treatment is also recommended. If a grade 2 tear also occurs with injury to another knee ligament or results in long-term instability, surgery may be needed to restore the ligament's function.

Grade 3 tears are severe, complete tears, disrupting the entire ligament and often involving injury to other surrounding structures. In most cases, a healthcare provider will recommend surgery for the best possible outcome for the patient.

There are 2 types of surgery for a collateral ligament tear: repair and reconstruction. Repair of the MCL or LCL involves stitching the torn ligament back together. A repair may also be done with a suture augmentation technique that uses a large, flat suture to provide additional support. If the original ligament cannot be repaired, a reconstruction can be performed to replace the damaged ligament with a tendon graft.

After surgery is complete, rehabilitation will involve a series of steps over several weeks. This may include wearing a brace to keep the knee straight as it heals, using crutches to stay off the affected leg in the beginning, and physical therapy to gradually improve range of motion, strength, and balance. Though it can take just a few months or all the way up to a full year, return to sports and physical activity is possible for most patients.