MCL / LCL / PLC / ALL Reconstruction

Symptoms:

• Sharp pain and swelling on the inner knee

• “Pop” sensation at the time of injury

• Feeling of the knee giving way

• Pain during walking or twisting

• Clicking or locking if meniscus is involved

Diagnosis:

• Detailed history and physical exam

• X-rays to rule out fractures

• MRI to assess severity and associated injuries

• Tear type: partial, complete, or ligament avulsion

Treatment:

• Non-Surgical: Most partial MCL tears heal without surgery using bracing, physiotherapy, cryotherapy, anti-inflammatories, and activity modification

• Surgical (Repair/Reconstruction): For severe or avulsion injuries, the ligament is repaired or replaced with a graft; fixation and rehabilitation are planned based on technique

LCL – Lateral Collateral Ligament
The LCL runs along the outer knee and prevents outward bending (varus stress). LCL injuries often occur with other knee injuries.

Causes:

• Direct impact to the inner knee

• High-energy trauma like vehicle accidents

• Often associated with Posterolateral Corner (PLC) injuries or knee dislocations

Symptoms:

• Pain and swelling on the outer knee

• Pop at the time of injury

• Knee may feel unstable outward

• Walking may be possible but unstable

Diagnosis:

• Clinical examination and ligament stress tests

• X-rays to check for bony injury

• MRI to confirm tear and associated injuries

Treatment:

• Non-Surgical: Mild or partial LCL tears can heal with bracing, physiotherapy, anti-inflammatories, and cryotherapy

• Surgical (Repair/Reconstruction): Required for severe or avulsion tears; involves graft repair and tailored rehabilitation

PLC – Posterolateral Corner
The PLC is a complex area on the back and outer knee, including:

• LCL, Popliteus tendon, Popliteofibular ligament

• Supporting structures: biceps femoris tendon, arcuate ligament, meniscopopliteal fascicles, fabellofibular ligament

Function:

• Prevents outward knee bending (varus)

• Controls external rotation of the tibia

• Supports knee stability during early flexion (0°–30°)

• Assists cruciate ligaments in controlling forward/backward tibial movement

Importance:

• PLC injuries are often missed initially

• Untreated PLC injuries can cause chronic instability and failure of ACL or PCL reconstructions

Treatment Summary: