Top

Published in:

01-12-2012 | Review Article

Structure and function, injury, pathology, and treatment of the medial collateral ligament of the knee

Authors: Aaron Schein, George Matcuk, Dakshesh Patel, Christopher J. Gottsegen, Timothy Hartshorn, Deborah Forrester, Eric White

Published in: Emergency Radiology | Issue 6/2012

Abstract

The medial collateral ligament (MCL) is the most commonly injured ligament of the knee. There is a spectrum of injury severity, and injuries may be acute or chronic. The MCL is also frequently injured in conjunction with other knee structures. Clinical evaluation of the knee is important to assess the degree of surgical acuity, but magnetic resonance imaging can provide details about the injury that may not be obvious clinically. In addition to injury, MCL bursitis can occur and may be treated with needle aspiration and corticosteroid injection. This review article covers the anatomy and biomechanics of the MCL, its injury patterns and approach to management, and MCL bursitis.

Bollen S (2000) Epidemiology of knee injuries: diagnosis and triage. Br J Sports Med 34(3):227–228PubMedCrossRef

Myasaka KC, Daniel D, Stone ML et al (1991) The incidence of knee ligament injuries in the general population. Am J Knee Surg 4:3–7

Wijdicks CA, Griffith CJ, Johansen S, Engebretsen L, LaPrade RF (2010) Injuries to the medial collateral ligament and associated medial structures of the knee. J Bone Joint Surg Am 92(5):1266–1280. doi:10.2106/JBJS.I.01229 PubMedCrossRef

Daniel DM, Pedowitz RA, O'Connor JJ, Akeson WH (2003) Daniel's knee injuries: ligament and cartilage : structure, function, injury, and repair. Lippincott Williams & Wilkins, New York. http://www.loc.gov/catdir/enhancements/fy0711/2002035293-d.html

O'Donoghue DH (1950) Surgical treatment of fresh injuries to the major ligaments of the knee. J Bone Joint Surg Am 32(A:4):721–738PubMed

Abbott LC, Saunders JBDM, Bost FC, Anderson CE (1944) Injuries to the ligaments of the knee joint. J Bone Joint Surg Am 26 (3):503–521

Loredo R, Hodler J, Pedowitz R, Yeh LR, Trudell D, Resnick D (1999) Posteromedial corner of the knee: MR imaging with gross anatomic correlation. Skeletal Radiol 28(6):305–311PubMedCrossRef

De Maeseneer M, Van Roy F, Lenchik L, Barbaix E, De Ridder F, Osteaux M (2000) Three layers of the medial capsular and supporting structures of the knee: MR imaging-anatomic correlation. Radiographics 20 Spec No:S83–S89

Wijdicks CA, Ewart DT, Nuckley DJ, Johansen S, Engebretsen L, Laprade RF (2010) Structural properties of the primary medial knee ligaments. Am J Sports Med 38(8):1638–1646. doi:10.1177/0363546510363465 PubMedCrossRef

10.

Wilson WT, Deakin AH, Payne AP, Picard F, Wearing SC (2012) Comparative analysis of the structural properties of the collateral ligaments of the human knee. J Orthop Sports Phys Ther 42(4):345–351. doi:10.2519/jospt.2012.3919 PubMed

11.

Schweitzer ME, Tran D, Deely DM, Hume EL (1995) Medial collateral ligament injuries: evaluation of multiple signs, prevalence and location of associated bone bruises, and assessment with MR imaging. Radiology 194(3):825–829PubMed

12.

Yao L, Dungan D, Seeger LL (1994) MR imaging of tibial collateral ligament injury: comparison with clinical examination. Skeletal Radiol 23(7):521–524PubMedCrossRef

13.

Studler U, White LM, Deslandes M, Geddes C, Sussman MS, Theodoropoulos J (2011) Feasibility study of simultaneous physical examination and dynamic MR imaging of medial collateral ligament knee injuries in a 1.5-T large-bore magnet. Skeletal Radiol 40(3):335–343. doi:10.1007/s00256-010-0884-6 PubMedCrossRef

14.

Jones L, Bismil Q, Alyas F, Connell D, Bell J (2009) Persistent symptoms following non operative management in low grade MCL injury of the knee—the role of the deep MCL. Knee 16(1):64–68. doi:10.1016/j.knee.2008.09.002 PubMedCrossRef

15.

Fanelli GC, Stannard JP, Stuart MJ, MacDonald PB, Marx RG, Whelan DB, Boyd JL, Levy BA (2010) Management of complex knee ligament injuries. J Bone Joint Surg Am 92(12):2235–2246PubMed

16.

Miller MD, Osborne JR, Gordon WT, Hinkin DT, Brinker MR (1998) The natural history of bone bruises. A prospective study of magnetic resonance imaging-detected trabecular microfractures in patients with isolated medial collateral ligament injuries. Am J Sports Med 26(1):15–19PubMed

17.

McAnally JL, Southam SL, Mlady GW (2009) New thoughts on the origin of Pellegrini–Stieda: the association of PCL injury and medial femoral epicondylar periosteal stripping. Skeletal Radiol 38(2):193–198. doi:10.1007/s00256-008-0604-7 PubMedCrossRef

18.

Mendes LF, Pretterklieber ML, Cho JH, Garcia GM, Resnick DL, Chung CB (2006) Pellegrini-Stieda disease: a heterogeneous disorder not synonymous with ossification/calcification of the tibial collateral ligament-anatomic and imaging investigation. Skeletal Radiol 35(12):916–922. doi:10.1007/s00256-006-0174-5 PubMedCrossRef

19.

De Maeseneer M, Shahabpour M, Van Roy F, Goossens A, De Ridder F, Clarijs J, Osteaux M (2001) MR imaging of the medial collateral ligament bursa: findings in patients and anatomic data derived from cadavers. AJR Am J Roentgenol 177(4):911–917PubMed

20.

Lee JK, Yao L (1991) Tibial collateral ligament bursa: MR imaging. Radiology 178(3):855–857PubMed

21.

Wen DY, Propeck T, Kane SM, Godbee MT, Rall KL (2007) MRI description of knee medial collateral ligament abnormalities in the absence of trauma: edema related to osteoarthritis and medial meniscal tears. Magn Reson Imaging 25(2):209–214. doi:10.1016/j.mri.2006.09.014 PubMedCrossRef

22.

Marchant MH Jr, Tibor LM, Sekiya JK, Hardaker WT Jr, Garrett WE Jr, Taylor DC (2011) Management of medial-sided knee injuries, part 1: medial collateral ligament. Am J Sports Med 39(5):1102–1113. doi:10.1177/0363546510385999 PubMedCrossRef

23.

Narvani A, Mahmud T, Lavelle J, Williams A (2010) Injury to the proximal deep medial collateral ligament: a problematical subgroup of injuries. J Bone Joint Surg Br 92(7):949–953. doi:10.1302/0301-620X.92B7.23559 PubMedCrossRef

Title: Structure and function, injury, pathology, and treatment of the medial collateral ligament of the knee
Authors: Aaron Schein
George Matcuk
Dakshesh Patel
Christopher J. Gottsegen
Timothy Hartshorn
Deborah Forrester
Eric White
Publication date: 01-12-2012
Publisher: Springer-Verlag
Published in: Emergency Radiology / Issue 6/2012
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI: https://doi.org/10.1007/s10140-012-1062-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Structure and function, injury, pathology, and treatment of the medial collateral ligament of the knee

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 6/2012

Musculoskeletal: what is different in children? Jumping around and falls on floor: will not move right arm

Kidney–pancreas transplantation

Eliminating routine oral contrast use for CT in the emergency department: impact on patient throughput and diagnosis

Aortic dissection in osteogenesis imperfecta: case report and review of the literature

Dural metastases from prostate cancer mimicking acute sub-dural hematoma

What the emergency radiologist needs to know about treatment-related complications from conventional chemotherapy and newer molecular targeted agents