Lateral Collateral Ligament (LCL) Injury
The lateral collateral is a ligament located on the outer part of the knee joint. A Lateral Collateral Ligament (LCL) Injury is a sprain or tear to the lateral collateral ligament in the knee.
What are the other Names for this Condition? (Also known as/Synonyms)
- Knee Injury - Lateral Collateral Ligament (LCL)
- Lateral Collateral Ligament Sprain
- Torn LCL
What is Lateral Collateral Ligament (LCL) Injury? (Definition/Background Information)
- The lateral collateral is a ligament located on the outer part of the knee joint. A Lateral Collateral Ligament (LCL) Injury is a sprain or tear to the lateral collateral ligament in the knee
- Individuals who participate in athletic sports, such as football or basketball, have a higher risk of injuring their lateral collateral ligament
- Treatment for this condition depends on the type and severity of injury and involves both surgical and nonsurgical treatment methods
- The prognoses of Lateral Collateral Ligament Injuries are usually excellent with appropriate treatment
Depending on the severity of the injury, physicians usually classify a Lateral Collateral Ligament Injury into three different grades. These grades include:
- Grade I Lateral Collateral Ligament Injury: Grade I occurs when only a small number of ligament fibers have been stretched, but not torn
- Grade II Lateral Collateral Ligament Injury: Grade II occurs when the ligament fibers have been partially torn
- Grade III Lateral Collateral Ligament Injury: Grade III is a complete rupture of the ligament fibers in the knee
Who gets Lateral Collateral Ligament (LCL) Injury? (Age and Sex Distribution)
- Individuals of any age, gender, race, or ethnic group, may sustain a Lateral Collateral Ligament Injury
- Adults between the ages of 20-34 and 55-65 years old have the highest rate of incidence of the condition
- Lateral Collateral Ligament injuries occur equally in both men and women
What are the Risk Factors for Lateral Collateral Ligament (LCL) Injury? (Predisposing Factors)
Risk factors of a Lateral Collateral Ligament Injury include:
- Participation in any sports that involves a violent change of direction such as with football, cricket, or basketball
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
What are the Causes of Lateral Collateral Ligament (LCL) Injury? (Etiology)
The following factors may lead to a Lateral Collateral Ligament Injury.
- Participation in any sports that cause the knee to twist forcefully or rotate
- Squatting or lifting of heavy objects
- Sudden directional change causing abnormal pressure on the knee
- Direct trauma to the inside of the knee joint, which results in stress on the outside part of the joint
- Hyperextension of the knee
- Landing awkwardly on one’s knee
What are the Signs and Symptoms of Lateral Collateral Ligament (LCL) Injury?
The signs and symptoms of a Lateral Collateral Ligament Injury may include:
- Decreased range of motion in the knee, difficulty walking
- Pain and tenderness on the outside part of the knee
- Noticeable swelling in the knee
- A loud popping sound noticed at the time of injury
How is Lateral Collateral Ligament (LCL) Injury Diagnosed?
A Lateral Collateral Ligament Injury is diagnosed using the following methods:
- Physical examination: During a physical examination, the physician may check for any signs of tenderness and swelling in the knee. A physician may also test the range of motion in the knee. In addition to this, a complete medical history can aid in arriving at a definitive diagnosis
- X-ray of the knee: Although LCL Injuries do not show up on x-rays, they can help rule out other causes of knee injuries and help confirm the diagnosis
- Magnetic resonance imaging (MRI) of the knee: An MRI is a more detailed scan that uses a magnetic field to produce images, which allows a physician to view any damage to the bones and soft tissue to confirm the diagnosis
- Ultrasound imaging of the knee: High-frequency sound waves are used to generate a more detailed image of the knee. This can help determine if any loose cartilage is caught in the knee
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
What are the possible Complications of Lateral Collateral Ligament (LCL) Injury?
Complications of a Lateral Collateral Ligament Injury include:
- Chronic knee instability
- Prolonged and chronic pain
- Degenerative joint disease, such as osteoarthritis
How is Lateral Collateral Ligament (LCL) Injury Treated?
Both nonsurgical and surgical methods may be used to treat a Lateral Collateral Ligament Injury. However, treatment depends on the severity of the injury.
Nonsurgical treatment for Lateral Collateral Ligament Injury may include:
The RICE method is effective for a high percentage of sports-related injuries. RICE is an acronym for Rest, Ice, Compression, and Elevation.
- Rest: Any activity that aggravates the knee condition should be avoided. The physician usually advises individuals to refrain from activities, until the symptoms get better
- Ice: Applying ice to the knee may help decrease pain and reduce swelling
- Compression: Wearing an elastic compression bandage can help stop additional swelling and loss of blood
- Elevation: Elevating the knee helps to decrease swelling
- Non-steroidal anti-inflammatory medication, such as ibuprofen and naproxen, can help decrease the pain in the knee
- Physical therapy may help restore strength, as well as flexibility in the muscles
Surgical treatment for Lateral Collateral Ligament Injury may include:
- Knee arthroscopy: Arthroscopic surgery is a minimally-invasive surgical procedure that is used to visualize, diagnose, and repair the lateral collateral ligament using small instruments. During this procedure, a surgeon inserts a thin tube attached to a camera (a fibro-optic camera) into the joint via a small incision on the skin of the joint. Visualizing the joint via a camera helps the physician view the inside of the knee and to determine the treatment
- Knee ligament repair: Knee ligament repair is a procedure to repair or replace the lateral collateral ligament with surgery
How can Lateral Collateral Ligament (LCL) Injury be Prevented?
A few recommendations to help prevent Lateral Collateral Ligament Injuries include:
- Improve conditioning and strengthen the hamstrings. It has been proven that exercising regularly to strengthen the hamstrings and surrounding structures around the knee is very effective in decreasing the risk of a LCL Injury
- Wear appropriate safety equipment, such as a knee brace, while participating in certain high impact sports, like football, cricket, basketball. Individuals, who participate in such sports, should ensure that any safety equipment worn is properly adjusted and correctly fitted to provide support for the knee
- Warming-up prior to exercising
- Use proper technique when exercising so that there is a decreased stress on the knee
What is the Prognosis of Lateral Collateral Ligament (LCL) Injury? (Outcomes/Resolutions)
- When Lateral Collateral Ligament Injuries are properly diagnosed and treated, individuals usually make a complete recovery and usually regain full strength and range of motion in the injured knee
- However, complications, such as osteoarthritis in the knee, may develop in some individuals with a Grade III LCL Injury
Additional and Relevant Useful Information for Lateral Collateral Ligament (LCL) Injury:
The following DoveMed website link is a useful resource for additional information:
What are some Useful Resources for Additional Information?
American Academy of Orthopaedic Surgeons (AAOS)
6300 North River Rd. Rosemont, IL 60018-4262
Phone: (847) 823-7186
Toll-Free: (800) 346-2267
Fax: (847) 823-8125
National Institute of Arthritis and Musculoskeletal and Skin Diseases
1 AMS Circle Bethesda, MD 20892-3675
Phone: (301) 495-4484
Toll-Free: (877) 226-4267
TTY: (301) 565-2966
Fax: (301) 718-6366
National Rehabilitation Information Center (NARIC)
4200 Forbes Boulevard Suite 202 Lanham, MD 20706
Phone: (301) 459-5900
Toll-Free: 1 (800) 346-2742
American Orthopaedic Society for Sports Medicine (AOSSM)
6300 N River Road Suite 500 Rosemont, IL 60018
Phone: (847) 292-4900
Toll-Free: (877) 321-3500
Fax: (847) 292-4905
National Athletic Trainers' Association
2952 Stemmons Freeway Dallas, TX 75247-6196
Phone: (214) 637-6282
Fax: (214) 637-2206
American Physical Therapy Association
1111 North Fairfax St. Alexandria, VA 22314-1488
Phone: (703) 684-2782
Toll-Free: (800) 999-2782
Fax: (703) 684-7343
References and Information Sources used for the Article:
http://www.nlm.nih.gov/medlineplus/ency/article/001079.htm (accessed on May 22, 2015)
http://www.hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/knee_ligament_repair_92,P07675/ (accessed on May 22, 2015)
Helpful Peer-Reviewed Medical Articles:
Stanley, D. (2008). Lateral collateral ligament injury. In Treatment of Elbow Lesions (pp. 99-102). Springer, Milano.
Pollock, J. W., Brownhill, J., Ferreira, L., McDonald, C. P., Johnson, J., & King, G. (2009). The effect of anteromedial facet fractures of the coronoid and lateral collateral ligament injury on elbow stability and kinematics. JBJS, 91(6), 1448-1458.
Shin, Y. W., Choi, I. H., & Rhee, N. K. (2008). Open lateral collateral ligament injury of the interphalangeal joint of the great toe in adolescents during taekwondo. The American journal of sports medicine, 36(1), 158-161.
Haddad, M. A., Budich, J. M., & Eckenrode, B. J. (2016). Conservative management of an isolated grade III lateral collateral ligament injury in an adolescent multi-sport athlete: a case report. International journal of sports physical therapy, 11(4), 596.
Grawe, B., Schroeder, A. J., Kakazu, R., & Messer, M. S. (2018). Lateral collateral ligament injury about the knee: Anatomy, evaluation, and management. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 26(6), e120-e127.
Wei, B., Jin, C., & Chen, W. (2004). Control observation on treatment of acute ankle joint lateral collateral ligament injury by acupuncture at Taixi (KI 3) point of the healthy side. Chin Acupunct Moxibustion, 24, 248-50.
Warren, R. F. (2017). Editorial commentary: knee lateral collateral ligament injury is more common than we thought.
Tang, W. J., Jiang, C. G., Chen, L. R., Pang, Y., Li, J., & Huang, Y. (2013). Effects of acupuncture-moxibustion intervention on proprioception in athletes with lateral collateral ligament injury of ankle joint. Zhen ci yan jiu= Acupuncture research, 38(4), 314-318.
Kim, J. M., Park, B. M., Lee, S. H., Jeon, S. J., Shin, J. B., & Song, K. S. (2013). Surgical Management of Comminuted Avulsion Fracture of the Proximal Fibula with Lateral Collateral Ligament Injury-Technical Note. Journal of the Korean Fracture Society, 26(1), 77-80.