The medial collateral ligament (MCL)
Most commonly injured ligament in the knee
Usually injured with a valgus stress to the partially flexed knee
Can also occur with a blow to the lateral leg
Commonly injured with acute anterior cruciate ligament (ACL) injuries
The lateral collateral ligament (LCL)
Since both collateral ligaments are extra-articular, injuries to these ligaments may not lead to any intra-articular effusion
Affected patients may have difficulty walking initially, but this can improve when the swelling decreases
Pain along the course of the ligaments
Limited range of motion due to pain, especially during the first 2 weeks following the injury
Usually not needed for isolated MCL injuries
Should be used to evaluate possible associated cruciate ligament injuries
Should be done for LCL or posterolateral corner injuries to exclude associated injuries and to determine their significance
Table 41–6.Knee examination. ||Download (.pdf) Table 41–6. Knee examination.
|Maneuver ||Description |
|Inspection ||Examine for the alignment of the lower extremities (varus, valgus, knee recurvatum), ankle eversion and foot pronation, gait, “SEADS” (swelling, erythema, atrophy, deformity, surgical scars). |
|Palpation ||Include important landmarks: patellofemoral joint, medial and lateral joint lines (especially posterior aspects), pes anserine bursa, distal iliotibial band and Gerdy tubercle (iliotibial band insertion). |
Range of motion testing
|Check range of motion actively (patient performs) and passively (clinician performs), especially with flexion and extension of the knee normally 0–10 degrees of extension and 120–150 degrees of flexion. |
|Knee strength testing ||Test resisted knee extension and knee flexion strength manually. |
|Ligament Stress Testing |
Performed with the patient lying supine and the knee flexed to 20–30 degrees. The examiner grasps the distal femur from the lateral side, and the proximal tibia with the other hand on the medial side. With the knee in neutral position, stabilize the femur, and pull the tibia anteriorly using a similar force to lift a 10- to 15-pound weight.
Positive test: Excessive anterior translation of the tibia compared with the other ...