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Dr. Ali Abd El-Monsif Thabet. Rehabilitation of lateral collateral ligament. Lateral Collateral Ligament.
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Dr. Ali Abd El-Monsif Thabet Rehabilitation of lateral collateral ligament
Lateral Collateral Ligament • The lateral collateral ligament (LCL) is located on the lateral side of the tibiofemoral joint, beginning proximally from the lateral femoral condyle. The LCL then travels distally to the fibular head where it joins with the tendon of the biceps femoris muscle
Kinematics • The LCL is primarily responsible for checking varus stresses, and like the MCL, limits varus motion most successfully at full extension.
MCL tears are more common than LCL tears, but a torn LCL has a higher chance of causing knee instability.
Pathomechanics • Isolated injuries of LCL are the least common injury to the knee and account for only 2%of all knee injuries
Injury mechanisms • The LCL is most often injured when the knee is forced to hinge outward away from the body.
Injury mechanisms • It can also be torn if the knee gets snapped backward too far (hyperextended).
Grades • The extent of laxity determines the severity of the injury. • A grade 1 sprain the LCL is tender due to microtears with some hemorrhage and tenderness to palpation. However, there is no increased laxity and there is a firm end point. • A grade 2 sprain involves an incomplete tear with some increased laxity with varus stress at 30 degrees of flexion and minimal laxity in full extension, yet there is still a firm end point. There is tenderness to palpation, hemorrhage and pain on a varus stress test. • A grade 3 sprain is a complete tear with significant laxity on varus stress in 30 degrees of flexion and in full extension when compared to the opposite knee. No end point is evident, and pain is generally less than with grades 1 or 2. Significant laxity with varus stress testing in full extension indicates injury to the posterolateral joint capsule, the PCL. and perhaps the ACL.
Rehabilitation of lateral collateral ligament • Grade 1 Sprain: • The rehabilitation guidelines for a grade 1 or mild lateral ligament sprain can be split into 4 phases:
Grade 2-3 sprains For a grade 2 and particularly 3 sprain it is important that the ends of the ligament are protected and left to heal without continually being disrupted. The rehabilitation guidelines for a grade 2 or 3 lateral ligament sprain (more severe) can be split into 4 phases:
