MCL Tear

Question 1

What is the role of MCL

Answer 1

Valgus stabiliser

Question 2

How do MCL injuries occur

Answer 2

often injured when external rotational forces are applied to the lateral knee, such as a impact to the outside of the knee.

Question 3

How are MCL injuries graded

Answer 3

Grade 1 - mild injury, with minimally torn fibres and no loss of MCL integrity

Grade 2 - moderate injury, with an incomplete tear and increased laxity of the MCL

Grade 3 - severe injury, with a complete tear and gross laxity of the MCL

Question 4

What are the clinical features of MCL tear

Answer 4

Report a pop sound

Immediate medial joint line pain

Swelling - after some hours ( unless ACL/PCL also involved in which case u get haemarthrosis => immediate swelling )

Increased laxity - during valgus stress test

Question 5

How do you distinguish grade 2 and 3 MCL Tears clinically

Answer 5

Grade II is lax in 30 degrees of knee flexion but solid in full extension, whereas Grade III is lax in both these positions.

Question 6

What are the differential diagnosis

Answer 6

fractures, meniscal injury, and collateral ligament tears.

Question 7

How would you investigate MCL tears

Answer 7

X ray to rule out fracture

Gold standard => MRI

Question 8

How do you manage grade 1 MCL injury

Answer 8

RICE

Analgesia

Strength training

( recover in 6 weeks )

Question 9

How would you manage a grade 2 MCL injury

Answer 9

Analgesia

Knee brace

Weight bearing//strength training as tolerated

( recover to normal in 10 weeks )

Question 10

How would you manage grade 3 MCL injury

Answer 10

Analgesia

Knee brace

Crutches

surgery if needed ( distal avulsion on MRI )

( recovery in 12 weeks )

Question 11

What are the complications of MCL tears

Answer 11

Instability of the joint and damage to the saphenous nerve