Other Ligament Injuries (MCL, PCL, etc.)
Posterior cruciate ligament (PCL), one of four major ligaments of the knee, is situated at the back of the knee. It connects the thighbone (femur) to the shinbone (tibia). The PCL limits the backward movement of the shinbone. The posterior cruciate ligament is usually injured by a direct impact, such as a motor vehicle accident when the knee forcefully strikes against the dashboard or during sports participation when a twisting injury or overextension of the knee can also cause PCL injury.
Injuries to the PCL are graded based on the severity of injury. In grade I the ligament is mildly damaged and slightly stretched, but the knee joint is stable. In grade II there is a partial tear of the ligament. In grade III there is a complete tear of the ligament and the ligament is divided into two halves making the knee joint unstable. Such injuries can result in instability in the knee joint, knee stiffness that causes limping, and difficulty in walking.
Diagnosis of a PCL injury is made based on symptoms, medical history, and physical examination of the knee. The doctor may order a few diagnostic tests such as X-rays and MRI scan. X-rays are useful to rule out avulsion fractures where the PCL tears off a piece of bone with it. An MRI scan is done for better visualization of the soft tissues. PCL injuries are very rare and difficult to detect when compared to other knee ligament injuries.
Generally, surgery is considered in patients with a dislocated knee and multiple ligament injuries, including the PCL.
The Medial Collateral Ligament (MCL), a band of tissue present on the inside of your knee joint, connects your thigh bone and shin bone (bone of your lower leg). The MCL maintains the integrity of the knee joint and prevents it from bending inward.
Your MCL may get sprained or injured while twisting, bending or quickly changing direction. The sprain is classified into three degrees:
- First-degree sprain: Ligament fibers may be injured, but with no significant tear and no loss of integrity
- Second-degree sprain: Not all ligament fibers are torn. Ligament remains intact overall
- Third-degree sprain: Complete rupture of ligament and loss of overall integrity
MCL sprains occur due to sudden impact from the outside of your knee, most commonly while playing sports such as rugby and football. Sometimes, the MCL can get injured when the knee gets twisted or following a quick change in direction.
The symptoms of MCL sprain include:
- Tenderness and pain in the inner side of the knee
- Swelling and bruising
- Stiffness of the knee
- Difficulty in walking
- Bleeding and inflow of fluid into the joint
Your doctor will review your symptoms and medical history. Physical examination will be performed where your doctor checks the range-of-movement of your legs. An X-ray or MRI scan may be ordered to determine soft tissue injury, confirm the extent of damage, and assess the integrity of your knee.
MCL sprains are commonly treated by conservative procedures. You will be advised to take adequate rest and not to strain yourself. An ice pack may be applied for 10 to 20 minutes for every 1 to 2 hours to reduce swelling. You may be prescribed anti-inflammatory medicines to reduce the pain and swelling. Your doctor may recommend crutches and braces to support, protect and limit movement in your knee. Rehabilitation procedures and exercises for MCL sprains generally focus on regaining knee range-of-motion, muscle control and strength, and reduce swelling. Surgery is performed very rarely, in case of significant third-degree ligament injury.
Based on your extent of damage, your doctor will suggest the best possible treatment option to treat your MCL sprain.
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