The medial collateral ligament ( MCL ), or tibial collateral ligament ( TCL ), is one of the four major knee ligaments. It is on the medial side (in) knee joints in humans and other primates. Its main function is to resist the strength of valgus on the knee.
Video Medial collateral ligament
Structure
This is a broad, flat band, membrane, located slightly posterior to the medial side of the knee joint. It is attached proximally to the medial epicondyle of the femur immediately beneath the adductor tubercle; below to the medial condyle of the tibia and the medial surface of the body. This rejects the forces that will drive the medial knee, which in turn will produce valgus deformity.
The fibers of the posterior parts of the ligaments are short and backward when they fall; they are inserted into the tibia on the grooves for the semimembranosus muscle.
The anterior portion of the ligament is a flat band, about 10 cm in length, which leans forward as it descends.
It is inserted into the medial surface of the tibia's body about 2.5 centimeters below the level of the condyle.
Crossing over the bottom of the MCL is the pes anserinus, the tendons join from the muscles of sartorius, gracilis, and semitendinosus; bursa interwoven between the two.
The inner surface of MCL includes the inferior medullary and inferior medial nerves and the anterior portion of the semimembranosus muscle tendon, which is linked by several fibers; it is very attached to the medial meniscus.
Development
Embryologically and phylogenically, the ligament represents the distal portion of the muscle adductor magnus. In lower animals, adductor magnus inserts into the tibia. Because of this, the ligament sometimes contains muscle fibers. This is an atavistic variation.
Maps Medial collateral ligament
Clinical interests
Injuries
MCL injuries can be very painful and are caused by the pressure of valgus to the slightly bent knees, often when landing, bending or high-impact. It may be difficult to apply pressure on the injured leg for at least several days.
The most common knee structure damaged in skiing is the medial collateral ligament, although lap carving has reduced the incidence. MCL strains and tears are also quite common in American football. Centers and guards are the most common victims of this type of injury due to trending grip on their cleats, although sometimes can be caused by helmets that hit the knee. The number of injured football players has increased in recent years. The company is currently trying to develop better cleats that will prevent injury. MCL is also strongly affected in breaststroke and many professional swimmers suffer from chronic MCL pain.
Treatment
Depending on the level of injury, the lowest score (grade 1) can take between 2 and 10 weeks for the injury to fully heal. Recovery time for classes 2 and 3 can take several weeks to several months.
Treatment of a torn or partial strain is usually conservative. Physical therapy should be the first choice for treatment and diagnosis of injury to this structure. These include measures to control inflammation and strengthen. Kannus has shown good clinical results with conservative care of a class II sprain, but poor outcomes at level III dislocate. As a result, more severe grade III and IV injuries to MCL leading to ongoing instability may require arthroscopic surgery. However, medical literature considers surgery for the majority of MCL injuries to be controversial. Constrained MCL sprained common.
For higher MCL tears with ongoing instability, MCLs can be stitched or replaced. Other non-surgical approaches to more severe MCL injuries may include prolotherapy, which has been demonstrated by Reeves in small RCTs to reduce translation at KT-1000 arthrometer compared with placebo. The future of non-surgical treatment for non-healing MCL injuries with weakness (partial ligament tear) may be bioengineering. Fan et al. (2008) have shown that ligament knee reconstruction is possible using mesenchymal stem cells and silk scaffolds.
Additional Images
See also
References
External links
- lljoints at The Anatomy Lesson by Wesley Norman (Georgetown University) ( antkneejointopenflexed )
- Ligament Medial Late Tears (MCL)
Source of the article : Wikipedia
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