Inner collateral ligament rupture

Anatomy: The bones in the knee joint comprise the thigh bone (femur), shin bone (tibia) and the knee cap (patella). There is furthermore a small joint between the shin bone and the calf bone (fibula). The knee joint is strengthened by a joint capsule which is in turn strengthened on the sides by an outer and an inner collateral ligament (ligamentum collaterale laterale (LCL) and ligamentum collaterale mediale (MCL)). Inside the knee there are two ligaments, the anterior and posterior cruciate ligaments (ligamentum cruciatum anterius and ligamentum cruciatum posterius).

Symptoms: Sudden pain on the inside of the knee. Occasionally a snap is felt when the ligament ruptures. In severe cases the athlete complains about a sense of looseness in the knee.

Acute treatment: Click here.

Examination: If a total or partial rupture of the ligaments in the knee is suspected, you should seek medical attention for a diagnosis. The doctor can perform various knee tests (internal side-instability-test) to examine the stability of the knee. If the knee is stable the injury is called a “sprain” of the inner side-ligament. If the knee is loose the injury is called a “rupture” of the ligament. The diagnosis is usually made from a normal medical examination. If there are any doubts surrounding the diagnosis, an ultrasound scan can be performed which will reveal the rupture and the bleeding along the ligaments (Ultrasonic image) .

Treatment: The treatment of a partial or total rupture of the inner side-ligament involves relief and rehabilitation. If the knee is markedly loose, you can, for a short period, use a support splint (Don Joy). Surgical treatment previously considered has today largely been abandoned in uncomplicated ruptures of the inner side-ligament (article). (However if the rupture of the inner side-ligament is combined with other ligament ruptures, many would recommend surgery).

Bandage: Hinge bandages can be used initially (Don Joy). Tape treatment of ligament ruptures in the knee have no sure effect.

Complications: If smooth progress is not achieved, it should be considered whether the diagnosis is correct or whether complications have arisen. Supplementary examinations (X-ray, ultrasound, MR scan or arthroscopy) will often be required. The following should be considered:

• Meniscus lesion
• Rupture of the anterior cruciate ligament
• Rupture of the posterior cruciate ligament
• Cartilage damage (osteochondral lesions)
• Bone membrane tear (periosteal avulsion)
• Tendinitis
• Fluid accumulation in the joint (traumatic arthritis/synovitis)
• Bursitis
• Inflamed mucous fold (plica synovialis)

An inflammation by the ligament fastening is sometimes seen later in the course of the injury, and in some cases bursitis at the ligament fastening is seen. The inflammation and bursitis can possibly be treated with medication (rheumatic medicine (NSAID) or injection of corticosteroid), if further relief has no effect.

Special: Since there is a risk that the injury can cause permanent disability, the injury should be reported to your insurance company.