Medial collateral ligament






The medial collateral ligament (MCL), or tibial collateral ligament (TCL), is one of the four major ligaments of the knee. 



It is on the medial or inner side of the knee joint  and its  primary function is to resist outward turning forces on the knee.



It runs from medial epicondyle of the femur to the medial condyle of tibia.



It resists forces that would push the knee medially, which would otherwise produce valgus deformity.



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 and are inserted into the tibia above the groove for the semimembranosus muscle.



The anterior part of the ligament is a flattened band, about 10 centimeters long, which inclines forward as it descends.



It is inserted into the medial surface of the body of the tibia about 2.5 centimeters 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.



The  ligament represents the distal portion of the tendon of adductor magnus muscle. 



An MCL injury can be very painful. 



A MCL injury is caused by a valgus stress to a slightly bent knee, often when landing, bending or on high impact. 



It is difficult to apply pressure on the injured leg for at least a few days. 



It also can be caused by a direct blow to lateral side of knee. 



The most common knee structure damaged with skiing is the medial collateral ligament.



MCL strains and tears are common in football, due to the grip trend on cleats.



Isolated MCL sprains are common.



MCL is also crucially affected in swimmers.



Levels of MCL injury: 



Grade 1 is a minor sprain



Grade 2 in a major sprain or a minor tear.



Grade 3 is a major tear. 



Based on the grade of the injury treatment options will vary. 



Treatment depends  on the grade of the injury:



Grade 1 injuries can take between 2 and 10 weeks to fully heal. 



Recovery times for grades 2 and 3 can take several weeks to several months.



Treatment of a partial tear or stretch injury is usually conservative. 



Treatment includes measures to control inflammation as well as bracing. 



Results with conservative care of grade II sprains is good.



More severe grade III and IV injuries with ongoing instability may require arthroscopic surgery. 



Surgery for most MCL injuries to be controversial.



For high grade tears of the MCL with instability, the MCL can be sutured or replaced. 



Nonsurgical approaches for more severe MCL injuries may include prolotherapy are under investigation.




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