Collateral ligament injuries
The collateral ligaments are two of the four main ligaments of the knee joint. Together with the cruciate ligaments, they contribute to knee stability. The medial collateral ligament (MCL) and lateral collateral ligament (LCL) are located on the inside and outside of the knee respectively, connecting the femur to the tibia. Due to their specific anatomy, they play a vital role in protecting the knee against varus/valgus stress (knee pushed in or out) and in maintaining the joint's rotational stability. MCL and LCL injuries generally occur when an external force, pushing the knee joint inwards or outwards, is applied to the lower limb. Although these injuries are primarily caused by contact, they can also occur without contact, particularly in multidirectional sports involving high-intensity actions. Due to their high-energy injury mechanisms, associated damage to other surrounding structures is also common. Ligament tears are generally classified according to severity on a three-grade scale. Grade I, often referred to as a sprain, is the mildest injury, while grade III, characterized by a complete tear, represents the most severe level of damage. Patients suffering from MCL or LCL injuries generally report
The medial collateral ligament (MCL) has a high intrinsic healing capacity, making conservative treatment the most commonly used therapeutic strategy for minor to moderate tears (grades I and II). In the case of higher-grade tears, severe instability or more intense symptoms, surgical treatment (repair or reconstruction) may be considered.
In the case of the lateral collateral ligament (LCL), due to its injury mechanisms often associated with high-energy trauma, high-grade tears and associated lesions are frequently observed. In these cases, the surgical approach (repair or reconstruction) is most recommended to restore stability to the injured ligament and simultaneously treat other reported damage to surrounding structures. In the case of minor injuries, as with MCL, a conservative approach is a valid and less invasive option.
Whatever rehabilitation strategy is implemented, a period of ligament protection is generally prescribed. This includes the use of a splint to limit lateral and rotational stresses, crutches to reduce the overall load on the lower limb, and progressive restoration of range of motion. As with many other injuries, it is strongly recommended to begin rehabilitation as soon as possible, and to consult a specialized rehabilitation center.