What is a MCL Knee Injury

An MCL injury is a sprain or tear to the medial collateral ligament. The MCL is a band of tissue on the inside of your knee. It connects your thigh bone to the bone of your lower leg. The MCL keeps the knee from bending inward.

James Dreese

James Dreese

Orthopaedic Surgeon
Lutherville, MD
Dr. Jack Rocco

Dr. Jack Rocco

MD
Orthopaedic Surgeon
Hollidaysburg, PA
Dr. Jamal Rakem

Dr. Jamal Rakem

Orthopaedic Surgeon
Welland, ON

Dr. Jordan Leith, MD, MHSc, FRCPC, Orthopedic Surgeon, discusses MCL (Medial Collateral Ligament) knee injuries.

Larissa Roux, MD FRCP Dip Sport Med, MPH, PhD, discusses MCL tears in hockey.

Behnad Honarbakhsh, MPT, BHK, CSCS, CAFCI, D.O.(c), discusses MCL injuries in skiing.

 

Audrey Spielmann, MD FRCP(C), discusses MRI Scans for Knee Injuries and When They Are Important.

 

MCL (Medial Collateral Ligament) knee injuries.

An MCL sprain is an injury to the medial collateral ligament of the knee. A sprain defines that it’s a ligament, and it’s a stretching injury to ligaments.

Looking on a model of the knee, again, we’ve got the kneecap, your thighbone, your shinbone. This is the medial side of the knee and the lateral side of the knee. The medial collateral ligament is this structure that runs along the medial side of the knee, and it stops the knee from opening medially.

So when you injure the medial collateral ligament, you stretch this ligament. It usually is injured from a blow to the lateral side of the knee that causes the stretch to the medial collateral ligament.

That’s what results in a medial collateral ligament sprain. There’s a number of degrees of sprains, from 1 to 3, 3 being the worst, which is a complete tear of that ligament.

The majority that we see are Grade 1 and 2, and they’re just a stretch and a little more significant stretch. They’re usually treated non-surgically. They rarely require surgery. If you do have a medial collateral ligament sprain, you will have pain along the medial side of your knee. You will have some swelling. You will have stiffness.

The best way to treat them initially is with ice and rest and anti-inflammatories. You should potentially see your family doctor if these symptoms are more significant.

Your family doctor may choose to refer you to a physiotherapist for treatment. If physiotherapy does not relieve your symptoms within the first six to eight weeks, then you may be best to be referred to a surgeon.

If you have any questions regarding an MCL injury or you think you have an MCL injury that you have further concerns about, then I would seek consultation with your family doctor.

Video Title: MCL (Medial Collateral Ligament) knee injuries.

Presenter: Dr. Jordan Leith, Orthopaedic Surgeon, Burnaby, BC

Local Practitioners: Orthopaedic Surgeon

Quiz: Do You Understand MCL (Medial Collateral Ligament) Knee Surgery?

Test your knowledge by answering the following questions:

Questions
True
False
1

Medial collateral ligament sprains range in degrees of severity from 1 to 5.

Explanation:
Medial collateral ligament sprains range in degrees of severity from 1 to 3, with 3 being the worst (a complete tear of the ligament). The majority of MCL injuries are grade 1 and 2, and are generally treated non-surgically.
2

These injuries are common in sports such as downhill skiing and hockey, as are ACL tears.

Explanation:
These injuries are common is sports such as downhill skiing and hockey, as are ACL tears. It occurs when there is a valgus load to the knee, which is when the force is coming from the outside and the ligament on the inside gets stretched or twisted.
3

Symptoms of a medial collateral ligament sprain include pain along the medial side of your knee, swelling and stiffness.

Explanation:
Symptoms of a medial collateral ligament sprain include pain along the medial side of your knee, swelling and stiffness. You should see your family doctor if these symptoms are more significant.
4

The best initial treatment for an MCL injury is usually surgery.

Explanation:
The best initial treatment is with the RICE protocol (rest, ice, compression and elevation) and anti-inflammatories. On average, it takes six weeks for an MCL injury to heal.
5

MCL reconstruction surgery is done arthroscopically.

Explanation:
MCL reconstruction surgery is rarely required, but if it is it’s typically done through a small incision on the inside of the knee. It cannot be done arthroscopically, as the medial collateral ligament is not inside the knee joint.
(Answer all questions to activate)

MRI Scans for Knee Injuries and When They Are Important

The MRI is the best way to look at disc herniations and to see the effect of the herniation on the nerve roots. We can see disc herniations with CT as well but we can’t identify the exact relationship to the nerve roots, or to the spinal cord higher up in the spine.

So there is much greater detail with MRI. This is an example of a lumbar spine MRI on an ahtlete who plays hockey and there are the normal disc spaces within the spine.

At this level the disc space is lost and we can see disc material extending into the spinal canal. This is a very large disc herniation that is pressing on the nerve roots within the spinal canal. The CT scan demonstrates the bones nicely and is very helpful if we’re concerned of a spine fracture.

What we don’t see as well on CT are the soft tissues, particularly in the lower lumbar spine there can be quite a bit of artifact and the detail within the disc herniation is not as well seen.

In particular we don’t see the impingement or compression of the nerve roots with CT, nor do we see the spinal cord with CT, so MRI gives us much better resolution.

The other benefit of MRI, we can view the anatomy in multiple planes. This is an axial image of the same area the disc herniation can be seen here. It’s a very large disc herniation. What MRI can do for us is identify the nerve roots which are not seen specifically with CT. We can identify the degree of compression of the nerve roots.

The detail shown with MRI helps the surgeon decide whether surgery is needed for disc herniation or just if conservative management is sufficient. If you have any questions about lumbar spine MRI contact your family doctor or an imaging center.

Presenter: Dr. Audrey Spielmann, Radiologist, Vancouver, BC

Local Practitioners: Radiologist

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