Lateral collateral ligament (LCL) injury

• Grade 1 few fibers of the LCL are torn. This is mild grade and often referred to as a sprain of a ligament in MRI reports.
• Grade 2 is a moderate injury where a partial tear means a significant number of fibers are torn, but continuity is maintained.
• Grade 3 is the most severe type in which complete ligament rupture or tear and continuity are absent.

• Pain in the outer part of the knee joint
• Swelling of the knee joint
• Instability/ difficulty in maintaining balance with the knee joint in a straight position
• Not able to maintain balance climbing up or down stairs
• Not able to play sports, do gym, dance, and do daily activities

Physical examination, X rays, and MRI diagnose LCL injury.

In most cases of grade 1 and grade 2, tear of LCL

• Ice packing
• Pain killers
• Knee braces for 4-6 weeks
• Protected weight bearing with the help of crutches/ walker for 1 week
• Physical therapy can be started after 3 weeks with continuing brace support
• The patient can resume his duties in concern with the treating surgeon. 

Results are good, and the patient will be fully functional after treatment, usually within 6-8 weeks.

• In grade 3, injury surgery is required.
• If any other ligament is also injured with LCL, including posterolateral complex, acl, PCL.

• The best surgical treatment for LCL injury is LCL reconstruction surgery. It involves the use of a graft from the patient body and is placed in a position where there original LCL was placed.
• Proper positioning of the graft is of utmost importance. Most cases of reinjury or failure of reconstructions occur due to wrong or misplaced positions of tunnels inside the femur or tibia bone. A good surgeon always focuses on making the tunnel accurate, as differences in position (in millimeters) can cause increased failure rates.

The ligament is secured in place with the help of fixation devices.

Fixation devices used in ACL reconstruction are screws.

• Screws used in ACL reconstruction surgery can be bioabsorbable or hydroxyapatite coated.
• Bioabsorbable screws dissolve inside the bone. These screws are usually absorbed within 2 years and don't cause inflammation, clinical problems, or reactions. But further studies are required to know about detailed properties.
• Hydroxyapatite coated screws

Hydroxyapatite is naturally present in the bone and teeth of humans up to 50% volume and 70% weight.

• Screws coated with hydroxyapatite have a natural tendency to fix the bone.
• They also help in increased bone formation and better healing.
• Reduces infection risk
• Less chances of allergies or other sensitivities
• They are better for X-ray and other imaging as they are radiopaque hence better visibility.

The ultimate decision of choosing between types of screws should be taken in consultation with the surgeon.

This technique is used only if sufficient LCL is present, which can be repaired. In cases where a long time has occurred and very little tissue is present to repair, this technique is not possible. This is one of the new techniques which is in use. This technique involves

• LCL repair; instead of LCL reconstruction, no graft is taken, and the original LCL is repaired.
• Fiber tape is used to provide strength to repaired LCL.

Although it provides better functional outcomes, few studies are present to support the current concept. Many studies have concluded no difference between LCL reconstruction and LCL repair with the internal brace technique. Detailed studies are further required to provide depth knowledge.

The patient usually has to wear a brace for 6 weeks post LCL reconstruction, and till then, he has to use crutches or a walker to walk. After that, the patient can put weight on the leg.

Usually, it takes 6 months for a full recovery and returns to heavy duty or sporting activities.

Usually, it depends on the patient's medical condition; if the patient is not suffering from any disease before surgery, hospital stay is for 2-3 days.

You can shower within 2-3 days after ACL reconstruction surgery. Usually, waterproof dressing is applied to the wound, after which the patient can shower. But to take a bath or swim a patient will require 4-6 weeks. The patient has to keep the wound dry and avoid using hot water as it increases swelling. 

It depends on the hospital category chosen by patients and the type of implant discussed. At Simpainortho.com, we have tried to reduce the cost of surgery and hospital expenses and include complete after-surgery services, which patients require after surgery because we know treatment doesn't end at the patient's discharge. To ensure the quick recovery of patients in simpainortho.com, a patient requires expert care within the most comfortable surroundings until he can join routine activities. So, we have made different packages for different patients according to need, and that too at the most affordable prices.

Yes, most of the insurance has included LCL reconstruction surgery.