With good physical examination, the Lateral collateral ligament (LCL) injury is relatively easy to identify. However, to establish the extent and grade of injury, further investigations would be helpful.
X-ray. X-ray is performed and is useful to rule out any bone injuries. Ligaments are not visible on the X-ray.
MRI Scan. MRI Scan is the gold standard investigation to identify the type and extent of the MCL injury. In addition, it helps to assess the condition of the meniscus (cushions in the knee joint), cartilage and other ligaments. Often these structures are also affected and need attention.
First Aid for LCL injuries involves the typical R.I.C.E therapy for the first week.
Rest. It is important to minimize walking around.
Icepacks. Cold packs 3 to 4 times a day helps reduce the swelling
Compression. Crepe bandage is sufficient to help with compression.
Elevation. Keeping it elevated on a pillow when resting helps.
Isolated LCL injury can be treated with Range of motion (ROM) knee brace in most patients. The angle of bending the knee is adjusted gradually. For the complete healing of the ligaments around 6 to 8 weeks of time is necessary. By 3 weeks, reassessment can help to understand the progress of the healing.
PCL + LCL Injury (Postero lateral corner injury)
This is more common type of injury. In patients with multi ligament injury, surgery to recontruct the postero lateral corner and also PCL ligament is expected to achieve the best outcome. Whether this is performed as 1 stage or 2 stage operation is tailor made to individual's inury pattern.
LCL reconstruction surgery is a day care surgery in which the torn ligament is replaced by your own spare piece of tissue. This is called auto-graft. Graft material can be obtained from cadaver source (another person), however own tissue is preferred and the healing and take up of the material is better. Hamstring muscle tendon from the inner side of the thigh is used. The two ends of the tendon is fixed to the thigh bone (femur) by using a biocomposite screw or titanium button and midportion to the leg bone (fibula) with a suture anchor made of either PEEK (high grade polymer) or biocomposite material.
Post-surgery, you are allowed to walk with partial weight on the same day evening. You will need the ROM knee brace for upto 3 weeks. Physiotherapy exercises start early. In the first 6 weeks the focus is mainly on getting the full ROM and help regain the muscle strength. The whole rehabilitation process will take about 4 to 6 months before returning back to playing sports on the ground or court.