Knee LCL Injury Specialist

Lateral collateral ligament (LCL) tears most often occur when there is a direct hit or blow to the inside of the knee, forcing the knee to the outside. Common symptoms of an LCL tear or injury are similar to other knee ligament injuries such as pain, swelling, instability and stiffness. Lateral collateral ligament injury specialist, Doctor Riley J. Williams provides diagnosis as well as surgical and nonsurgical treatment options for patients in Manhattan, New York City, NY who have sustained an LCL injury. Contact Dr. Williams’ team today!

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What is an LCL Injury?

The lateral collateral ligament is a thin band of issue running down the outer or lateral side of the knee. The LCL that connects the femur (thighbone) to the fibula (small lower leg bone). It is one of four main knee ligaments. The LCL is one of the main knee stabilizing ligaments. An LCL injury, such as a tear, usually occurs from a direct blow to the inside of the knee. Sports that require quick changes in direction like soccer or skiing can stretch the lateral collateral ligament to the point of tearing; sports (i.e. football) where collisions are common can are also associated with LCL injuries.  An LCL injury can also occur from repeated stress, which causes it to lose its normal elasticity. LCL tears are not as common as MCL or ACL tears, and can also occur with other injuries such as knee dislocations. Dr. Riley J. Williams, orthopedic knee specialist, serving Manhattan, New York City, and the surrounding New York boroughs, has extensive experience in treating LCL tears and other issues related to an LCL injury and LCL insufficiency issues.

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LCL Injury

What is a lateral collateral ligament injury?

A lateral collateral ligament injury occurs when the outer side of the knee is stretched beyond its normal stretching capacity. If the knee takes a direct hit on the inner side of the knee, it can push the knee outward, resulting in an LCL injury. A lateral collateral ligament injury can also occur if the knee is hyperextended, which is when the knee straightens “too far” or too forcefully. Lateral collateral ligament injuries can be partial or complete. Complete injuries usually result in frank knee instability.

What is an LCL insufficiency?

LCL insufficiency occurs when the lateral collateral ligament is not functioning and does not hold the knee stable. Following a complete LCL injury, knee pain will improve but knee instability will continue due to the persistence of LCL insufficiency. LCL insufficiency can be the result of overuse or can occur from a previous injury. Athletes who have repeatedly damaged their knee, or who have stretched the LCL too far may experience a weakened knee feel like it may give out while standing or walking. The LCL is responsible for knee stabilization, specifically on the outer side of the joint.

What are the Symptoms of an LCL tear or injury?

Individuals in the New York area who experience an LCL tear commonly report the following symptoms:

  • Bruising on the outside of the knee
  • Inability to bear weight
  • Decreased range of motion
  • Swelling on the outside of the knee
  • Tenderness on the outside of the knee
  • Pain on the outside of the knee
  • Catching or locking of the knee
  • Numbness in the foot
  • Knee collapse or giving way

How is an LCL tear, injury or insufficiency diagnosed?

LCL injuries are broken down into grades ranging from 1-3. Grade 1 and 2 injuries are partial tears, and grade three injuries are complete tears or ruptures of the LCL. Dr. Williams will begin his diagnosis by inquiring about the events that lead to the injury, where the site of pain is and if the patient has experienced past knee injuries. Dr. Williams will perform a physical examination. Dr. Williams will check on the integrity of the LCL using the varus stress test. During this test, the patient lies on their back while the doctor places one hand on the knee and one hand on the ankle while carefully moving the knee from side to side by moving the ankle. Excess side to side movement could indicate an LCL tear. Dr. Williams will order imaging tests which include x-ray and MRI scan to check for injuries to the ligaments and other knee structures.

What are the treatment options for an LCL tear?

Non-surgical treatment:

Dr. Williams may recommend the RICE method: rest, ice, compression and elevation for mild or incomplete LCL injuries. Non-steroidal anti-inflammatories, such as ibuprofen, can help with pain and swelling. He may recommend the use of a brace for added knee support, and physical therapy to regain strength, range of motion, and normal knee function.

Surgical treatment:

The lateral collateral ligament does not heal well on its own, unlike a medial collateral ligament tear (MCL tear). Injury to the LCL may necessitate  surgery, depending on the severity of the tear. The two most common types of surgery used to address LCL tears or injuries are:

  • LCL Repair – Done when there is a complete tear of the LCL, and the ligament is torn in near one of its native insertion sites on the femur or fibula. If the ligament tissue is viable, Dr. Williams may be able to sew or attach the LCL pieces back to its proper anatomical position.
  • LCL Reconstruction – Done when an LCL injury or tear when the LCL has torn substantially, in the middle, and is not reparable. If the ligament cannot be repaired, Dr. Williams will reconstruct the ligament using a tissue graft replacement.  Tissue taken from the patient (autograft) or a donor (allograft) can be used for LCL reconstruction. Most patients will be able to leave the hospital the same day as surgery. The patient will need crutches for up to 2-3 weeks, a brace and rehabilitation for 2-3 months following LCL reconstruction. All rehabilitation protocols are personalized by Dr. Williams to fit the patient’s specific needs.

For more information on LCL tears, injuries or lateral collateral ligament insufficiency and the treatment options available, please contact the office of Riley Williams, MD, orthopedic knee specialist serving Manhattan, New York City and the surrounding New York boroughs.

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212.606.1855
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Locations

HSS Sports Medicine Institute West Side
610 W 58th Street
New York, NY 10019

HSS Brooklyn
148 39th Street, 7th Floor
Brooklyn, NY 11232

Office Hours

Monday-Friday: 9:00 am – 4:30 pm
Fax: 212-774-2895