There are two collateral ligaments located within the knee complex: the medial collateral ligament (MCL) and the lateral collateral ligament (LCL). These extra-articular ligaments are found on the outside of the knee joint and function to stabilize and protect the knee joint. The medial collateral ligament (MCL) emanates from the medial epicondyle, a bony ridge on the inner femur, and attaches to the medial condyle, a bony ridge on the inner tibia. The lateral collateral ligament (LCL), also known as the fibular collateral ligament (FCL), emanates from the lateral epicondyle of the femur, a bony ridge on the outer femur, and attaches to the head of the fibula (smaller bone adjacent to tibia). The MCL prevents an inward collapse of the knee while the LCL prevents an outward collapse of the knee. The MCL is one of the most injured ligaments within the knee complex. An injury to this ligament is the result of a substantial force directly to the outer knee. An injury to the MCL is most common among athletes involved in aggressive contact sports.
Mild collateral ligament injuries can often heal with conservative therapies alone. However, if conservative therapy is unsuccessful, or in the event of a complete ligament rupture, surgical reconstruction of the collateral ligaments may be necessary to restore rotational stability. Surgical reconstruction of the collateral ligaments involves excising damaged tissue fragments, then suturing the remaining ligament pieces back together, or fastening them to the bone. On occasion, a tendon graft, harvested from the patient (autograft) or donor (allograft), may be integrated for irreparable ligament damage. Allografts are generally favored for tendon grafts as it makes for an easier recovery and reduces the risk of the ligament rupturing again. Dr. Frank McCormick, orthopedic knee doctor, treats patients in Orlando, Palm Beach County, and surrounding Florida communities, who have experienced a collateral ligament injury and are in need of surgical repair.
Collateral ligament reconstruction is frequently performed as an outpatient procedure. Prior to operating on the knee, an examination under anesthesia is performed to verify the torn ligaments. A tendon graft is then harvested from the patient or the donor tissue is thawed. A small camera (arthroscope) is inserted allowing Dr. McCormick to analyze the muscles, tendons, and ligaments of the knee joint. Specialized surgical instruments are then introduced to excise the damaged ligament fragments and complete any other necessary repairs. When the ligament has been successfully repaired, the remaining pieces can be sutured back together, or fastened directly to the bone with special surgical anchors. In the event of a complete ligament rupture, the tendon graft is situated as close to the native tissue to ensure a successful recovery. Bone tunnels are created through the inner distal femur and the inner proximal tibia for the new medial collateral ligament (MCL). The tendon graft is passed through these tunnels and fastened by interference screws or special surgical anchors. Lateral collateral ligament (LCL) reconstruction is similar except the bone tunnels are created through the outer distal femur and the head of the fibula. When the necessary revisions are complete, the new ligament is assessed for good tension and stability, and the knee’s range of motion is evaluated.
However, there are particular circumstances where Dr. McCormick recommends open surgery over arthroscopic reconstruction. Open surgery involves a slightly larger incision over the knee joint that allows Dr. McCormick to visualize the entire knee complex while conducting the necessary repairs. Open surgery is favored when the collateral ligaments sustain a significant amount of damage or there is damage to multiple, knee joint structures.
The recovery period following collateral ligament reconstruction depends on which ligament is repaired, the surgical approach utilized, and if a tendon graft was employed. A return to normal daily activities can be expected in approximately 2 to 6 weeks for the majority of patients in Orlando, Palm Beach County, and the surrounding Florida communities. Recovery has a higher likelihood of success when patients are compliant with the post-operative care instructions provided by Dr. McCormick. The following features can be expected following collateral ligament reconstruction:
For more information on meniscus tears of the knee, or the excellent treatment options available, please contact the office of Frank McCormick, MD, orthopedic knee specialist serving Orlando, West Palm Beach County, and surrounding Florida communities.
