|
|
|
|
Medial collateral ligament
|
| |
|
| |
The medial collateral ligament of the knee is one of the four major ligaments of the knee. It is on the medial (inner) side of the knee joint in humans and other primates. It is also known as the tibial collateral ligament, or abbreviated as the MCL.
s a broad, flat, membranous band, situated slightly posterior on the medial side of the knee joint. It is attached proximally to the medial condyle of femur immediately below the adductor tubercle; below to the medial condyle of the tibia and medial surface of its body.
Discussion
Ask a question about 'Medial collateral ligament' Start a new discussion about 'Medial collateral ligament' Answer questions from other users |
Encyclopedia
The medial collateral ligament of the knee is one of the four major ligaments of the knee. It is on the medial (inner) side of the knee joint in humans and other primates. It is also known as the tibial collateral ligament, or abbreviated as the MCL.
Structure
It is a broad, flat, membranous band, situated slightly posterior on the medial side of the knee joint. It is attached proximally to the medial condyle of femur immediately below the adductor tubercle; below to the medial condyle of the tibia and medial surface of its body. It resists forces that would push the knee medially, which would otherwise produce valgus deformity.
The fibers of the posterior part of the ligament are short and incline backward as they descend; they are inserted into the tibia above the groove for the semimembranosus muscle.
The anterior part of the ligament is a flattened band, about 10 centimetres long, which inclines forward as it descends.
It is inserted into the medial surface of the body of the tibia about 2.5 centimetres below the level of the condyle.
Crossing on top of the lower part of the MCL is the pes anserinus, the joined tendons of the sartorius, gracilis, and semitendinosus muscles; a bursa is interposed between the two.
The MCL's deep surface covers the inferior medial genicular vessels and nerve and the anterior portion of the tendon of the semimembranosus muscle, with which it is connected by a few fibers; it is intimately adherent to the medial meniscus.
Embryologically and phylogenically, the ligament represents the distal portion of the tendon of adductor magnus muscle. In lower animals, adductor magnus inserts into the tibia. Because of this, the ligament occasionally contains muscle fibres. This is an atavistic variation.
Causes of Injury
An MCL injury can be very painful and is often caused when the knee bends the wrong way when landing, or on high impact. It can take between 2 and 10 weeks for the injury to fully heal. It is difficult to apply pressure on the injured leg for at least a few days.
Skiing
The most common knee structure damaged in skiing is the medial collateral ligament, although the carve turn has diminished the incidence somewhat.
American Football
MCL strains and tears are fairly common in American football. Mostly the center and the guards are ones who get this injury, due to the grip trend on their cleats. The number of football players who get this injury has increased in recent years. Companies are currently trying to develop better cleats that will prevent injury.
Treatment
Treatment of a partial tear or stretch injury is usually conservative. This includes measures to control inflammation as well as bracing. Kannus has shown good clinical results with conservative care of grade II sprains, but poor results in grade III sprains.As a result, more severe grade III and IV injuries to the MCL that lead to ongoing instability may require arthroscopic surgery. However, the medical literature considers surgery for most MCL injuries to be controversial. Since isolated MCL injuries are uncommon, surgery is often focused on ACL replacement or repair with combined surgical approaches being common.
For higher grade tears of the MCL with ongoing instability, the MCL can be sutured or replaced. Other non-surgical approaches for more severe MCL injuries may include prolotherapy, which has been shown by Reeves in a small RCT to reduce translation on KT-1000 arthrometer versus placebo. The future of non-surgical care for a non-healing MCL injury with laxity (partial ligament tear) is likely bioengineering. Fan has demonstrated that knee ligament reconstruction is possible using mesenchymal stem cells and a silk scaffold.
Additional images
External links
|
| |
|
|
