Orthopedics

OSPI offers the top orthopedic surgeons in Gilbert AZ and the East Valley. Drs. Mahoney, Macqueen, Stewart and Clouse offer minimally invasive General, Sports and Joint Replacement expertise.

Physical Therapy

Whether you are pre or post-operative, OSPI’s East Valley physical therapy team works with you on both active and passive treatments. Your will be in the best hands with our licensed physical therapists!

Chiropractic

The Gilbert chiropractors at OSPI offer a plethora of nonoperative pain relief options such as manipulations, laser therapy, physiotherapy and electrical stimulation.

Family Practice

OSPI offers comprehensive family practice services including allergy testing, BHRT, medical weight loss, aesthetics and full check ups.

Medical Weight Loss

Patients routinely experience dramatic, healthy weight loss with the customized programs at OSPI. The programs combine nutrition, exercise and prescription weight loss options.

Performance Training

OSPI’s integrated team of healthcare providers work with both amateur and professional athletes to maximize one’s performance with sport specific programs.

Pain Management

OSPI’s Board Certified, Fellowship Trained pain doctor offers both medication management and interventional procedures with exceptional outcomes!

LCL Injury

FAQS on Lateral Collateral Ligament (LCL) Injury

 

Lateral collateral ligament or LCL injury is one of the regular sports injuries. The injury leads to instability in the knee and may damage other parts of the knee joint structure. The effects may include arthrofibrosis, hemarthrosis, knee arthritis, and even damage to the knee nerves.

What is LCL injury?

LCL injury indicates sprained or torn lateral collateral ligament located on the outer part of the knee joint. One among four key ligaments in the knee, the lateral collateral ligament keeps the thigh bone aligned with the tibia and fibula to prevent “excessive side-to-side movement of the knee joint.” Excessive varus force when overpowers its resistance limit, sprains and tears appear on the overburdened ligament.

According to the degree of severity, LCL injury is of three types.

  • Grade 1 LCL injury: Sprain in the ligament, no major impact, possible tears limited to very small number of fibers, healing within a few days.
  • Grade 2 LCL injury: Partial tear of the lateral collateral ligament, tears in significant number of fibers, moderate pain, instability, and functional loss.
  • Grade 3 LCL injury: Complete ligament tear, total rupture impacting all fibers, significant injury, pain, instability, and overall loss of function.

How does LCL injury occur?

LCL injury occurs when excessive force pushes the lateral collateral ligament beyond its resistance limit. The ligament keeps the knee stable from the outer side and resists any varus stress that may twist the knee. When the knee withstands any pressure or blow pressing outwards, the ligaments fends. But if the force is excessive, it is pushed to it farthest limit and even beyond causing sprain or tears.

LCL injury may also occur alongside ACL and PCL injuries. Twisting or pivoting also cause direct impact on the ligament and it may be torn in such conditions.

What are the symptoms of LCL injury? When to see a doctor?

  • Pain on the outer part of the knee
  • Swelling and tenderness at the place of pain
  • Knee joint stiffness, soreness, instability
  • Feeling of knee may give way
  • Loss of knee ability and motion
  • Locking, popping, or catching sensation while walking or stretching the knee
  • Weakness associated with knee nerve

What are causes LCL injury?

  • Excessive strain on lateral collateral ligament
  • Varus force across the knee
  • Stress on the outer part of the knee
  • Hard blow pushing the knee from inside
  • Forceful outward bending of the knee
  • Injury to cruciate ligaments
  • Sudden pivoting or change of direction while running
  • Tackling and collisions in contact sports
  • Traumatic blunt force impact on the outer knee area
  • Knee hyperextension stress
  • Landing from a jump
  • Repetitive stress on the ligament beyond its biomechanical limit

How is LCL injury diagnosed?

  • Physical Examination: Doctors examine the knee for LCL injury symptoms, including pain and swelling. Patients are asked about their medical history and any previous knee injury.
  • Imaging Tests: While ultrasound or MRI are recommended to spot injury to ligaments and muscles around the knee joint, x-rays help eliminate any chance of knee joint injury.

What are the treatment methods available for LCL injury?

  • Anti-inflammatory medications are prescribed to reduce swelling and pain and allow sprains and tiny tears to heal on their own.
  • Conservative Therapy: Self-care and adequate rest promotes healing. Cease activities that may stress the injured lateral collateral ligament. Wrapping a brace around the injured part also provide support and stabilization to the knee. Ice the injured are at regular intervals. Strengthening exercises are good to restore knee joint mobility and build up muscles around it. To avoid swelling and blood loss, always keep the knee elevated and higher than your heart.
  • Surgical Intervention: Surgery is an option only when the LCL injury is serious to impact the knee structure and cause future instability. Doctors stitch the torn ligament to repair the rupture. It may also be restructured by grafting parts of hamstrings tendon.
  • Anesthetic Injection: It assures relief from pain and swelling for weeks and helps overcome the inconvenience of daily intake of anti-inflammatory medications.
  • Prolotherapy (PRP/ Stem Cell Injection): The latest method on the block, it treats the LCL injury with stem cells or platelet rich plasma harvested from the patient’s blood. The two elements contain mesenchymal cells that can produce new cells and tissues replacing the torn and dead ones. When inserted in large quantities, they bring in overwhelming growth factors that sets the repairing process by replacing dead cells by new ones.

What are the likely outcomes and chances of LCL injury recovery? How long will it take to heal?

Fully recovery is for Grade 2 and Grade 3 tears may take 6 to 12 weeks. Gradually, progressive exercises help regain the pre-injury knee ability fast. Once the knee can perform its entire range of function without pain or other LCL injury symptoms, you are declared fit and free from injury.

References

Schorfhaar AJ, et al. Knee: Lateral and postereolateral injuries of the knee. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier;2009:chap 23;sect F.

De Carlo M, Armstrong B. Rehabilitation of the knee following sports injury.Clin Sports Med

Irrgang JJ, Fitzgerald GK. Rehabilitation of the multiple-ligament-injured knee. Clin Sports Med. 2000;19(3):545-571.

Meislin RJ. Managing collateral ligament tears of the knee. Phys Sportsmed. 1996;24(3):67-80.

Mark T. Wheaton & Nicole Jensen. The Ligament Injury-Osteoarthritis Connection: The Role of Prolotherapy in Ligament Repair and the Prevention of Osteoarthritis. Journal of Prolotherapy. 2011;3(4):790-812.

Ross A. Hauser & Erin E. Dolan. Ligament Injury and Healing: An Overview of Current Clinical Concepts. Journal of Prolotherapy. 2011;3(4):836-846.

Griffin LY. Acute knee injuries. Sports Medicine. New York, NY: John Wiley & Sons, Inc; 1994:2255-60.

Krukhaug Y, Mølster A, Rodt A, Strand T. Lateral ligament injuries of the knee. Knee Surg Sports Traumatol Arthrosc. 1998;6(1):21-5. [Medline].

Ruiz ME, Erickson SJ. Medial and lateral supporting structures of the knee. Normal MR imaging anatomy and pathologic findings. Magn Reson Imaging Clin N Am. Aug 1994;2(3):381-99.

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