Medial collateral ligament injury | Right Decisions

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Knee
Medial collateral ligament injury

Medial Collateral Ligament injury (MCL)

A tear of the ligament of the inner aspect of the knee. Usually a traumatic injury and are known to heal well without operative intervention.

History

Young to middle age
Fall or twist
Immediate pain
Possible effusion – slow onset
Difficulty weight bearing
Medial pain

Signs

Limp
Local tenderness
Possible effusion
Possilbe MCL laxity
Difficulty kneel/squat

MCL Injury

Pain on stressing MCL

Who to refer, who not to refer, how to refer

Who to Refer

Any confirmed MCL injury with ongoing symptoms and laxity
Associated injuries e.g ACL/ meniscal injuries

Urgent Referral Criteria

Associated injuries e.g ACL/ meniscal injuries
If referred into Orthopaedics - these types of injuries will be triaged as urgent in orthopaedic vetting

Who Not to Refer

Additional Info

Unlikely to require surgery
Most heal well with hinged knee brace and Physio
Unlikely to operate BMI >40

Imaging

MRI to be requested by Ortho only

How to refer

We accept referrals through SCI gateway for those who are based in Scotland.

We also accept e referrals through the below email address using the attached form for those who are based just on the other side of the border.

E- Referral Email address - bor.orthoreferrals@borders.scot.nhs.uk

Referral form - E-Referral to Orthopaedics (Non Sci-Gateway)

Primary care management

Brace Protocol- 0-90° 6/52
Physio rehab- strengthening over extended period (1yr)
Regular maximum multimodal analgesia
Education
BMI >35 engage in wellbeing support

Resources and links

Primary Knee Pathway - developed by First Contact Practitioners Primary Knee Pathway

Local service details

orthopaedics@borders.scot.nhs.uk

bor.orthoreferrals@borders.scot.nhs.uk