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Lateral Collateral Ligament Reconstruction
Lateral Collateral Ligament (LCL) Reconstruction
Lateral collateral ligament (LCL) reconstruction is an open surgical procedure performed to repair a stretched or torn LCL. This surgical treatment cannot be performed arthroscopically due to the position of the ligament which exists outside of the knee joint. Dr. Rahul Bade typically recommends this surgery be performed for patients who have experienced a significant lateral collateral ligament tear, patients who experience severe knee instability, or those who have been unable to alleviate the symptoms of an LCL tear through non-surgical methods. LCL reconstruction makes use of a tissue graft to replace the injured ligament. Tissue grafts used for LCL reconstruction can be taken from a donor (allograft) or taken from another area from the patient’s own body (autograft).
Symptoms
- Swelling of the knee (especially the outer aspect)
- Stiffness of the knee joint that can cause locking of the knee
- Pain or soreness on the outside of the knee
- Instability of the knee joint (feeling like it’s going to give out)
Diagnosis
- To diagnose an LCL injury, your doctor will examine your knee and look for swelling. They’ll also move your knee in various directions to determine where your pain is and how severe your symptoms are.
- If your doctor believes you may have a torn ligament, you may undergo imaging tests like X-rays or MRI scans. These tests will allow your doctor to see the soft tissues inside the knee.
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DIAGNOSIS OF LATERAL COLLATERAL LIGAMENT (LCL) INJURY.
Physical examination:
Physical examination includes observing the swelling, ecchymosis, and warmth along the lateral joint line. The patient is assessed for range of motion, muscle strength, sensation, reflexes, and palpation along the lateral joint line. Gait analysis and special tests are performed to determine associated ligamentous, meniscal, or soft tissue injuries.
X-ray:
X-ray of AP and Lateral side is used to rule out associated structural injuries. Varus and Posterior kneeling stress images are used to determine injury of LCL.
Magnetic resonance imaging (MRI):
Magnetic resonance imaging (MRI) is the gold standard in diagnosing LCL injuries. Coronal and Sagittal images are used in diagnosing an LCL injury.
Ultrasound:
Ultrasound is used in case of rapid diagnosis of LCL injury. Thickened and hypoechoic LCL indicates an LCL injury. In case of a complete tear, an ultrasound may show increased edema, lack of fiber continuity, dynamic laxity of the LCL.