Overview of LCL Pathology
In patients who have a complete lateral, or fibular collateral ligament (LCL), tear and noticeable side-to-side instability with activities, a lateral collateral ligament surgery is recommended. The term fibular collateral ligament (FCL) is more anatomically correct, but is more commonly referred to as lateral collateral ligament (LCL).
LCL surgery is very effective in restoring side-to-side stability to the knee and preventing varus gapping. During a clinical exam and varus stress radiographs, we will be able to confirm whether or not there is a complete LCL tear. It is important to note that an MRI scan can be inaccurate – especially in cases of a chronic situation where the LCL heals improperly – that is why it is important to properly analyze the pathology.
Treatment for LCL Injury
The treatment approach for an LCL (Lateral Collateral Ligament) injury depends on its severity. In less severe cases, the RICE method (Rest, Ice, Compression, and Elevation) along with anti-inflammatory medications (NSAIDs) and pain relievers can help relieve discomfort and reduce swelling. Physical therapy is also beneficial for improving strength and range of motion, ultimately aiding in the knee's recovery.
However, complete LCL tears typically require surgical intervention. This surgical procedure, often performed in conjunction with arthroscopy, involves replacing the torn lateral collateral ligament with a tissue graft. The graft is threaded through bone tunnels and securely attached to the femur and fibula using screws.
Post-Operative Protocol for LCL Surgery
Following LCL (Lateral Collateral Ligament) surgery, the rehabilitation process focuses on early knee range of motion. Typically, patients start with a range of 0 to 90 degrees on the first day after surgery and gradually progress over the next two weeks. It's essential to avoid isolated hamstring exercises during the initial four months post-operation. Patients should also refrain from putting weight on the injured leg for six weeks.
After six weeks, patients can gradually transition off crutches and begin using a stationary bike. However, activities involving side-to-side movements or step-ups should be avoided until varus stress X-rays are taken at five months post-operation to ensure sufficient graft healing. Athletes are often advised to use a secure brace to facilitate these activities and may need to wear it for up to a year after surgery to optimize graft healing.
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