From the Research
Management of a lateral collateral ligament (LCL) injury typically follows a conservative approach for most cases, with surgery reserved for severe injuries. The initial treatment includes the RICE protocol: rest, ice, compression, and elevation for 24-48 hours to reduce pain and swelling, as seen in various studies 1, 2. Pain management involves NSAIDs like ibuprofen (400-600mg three times daily) or naproxen (500mg twice daily) for 1-2 weeks. Physical therapy is crucial and should begin after acute symptoms subside, focusing on:
- Range of motion exercises
- Progressive strengthening of the lateral knee stabilizers
- Proprioception training
- Functional rehabilitation A hinged knee brace may be recommended during recovery to provide stability while allowing controlled movement. Most LCL injuries heal within 6-12 weeks with proper rehabilitation, though return to sports typically requires demonstration of full strength, stability, and functional capacity, as noted in a case report 1. Surgery becomes necessary for complete tears with instability, multi-ligament injuries, or when conservative treatment fails, usually involving direct repair or reconstruction using autografts or allografts, as described in a surgical technique article 3 and a case report 4. The LCL is critical for lateral knee stability, resisting varus forces, and its proper management is essential to prevent chronic instability and early osteoarthritis. It's worth noting that while some studies discuss surgical approaches 3, 4, the most recent and highest quality evidence supports a conservative approach as the first line of treatment, with surgery reserved for more severe cases or when conservative management fails. In the context of real-life clinical medicine, prioritizing a conservative approach aligns with minimizing morbidity, mortality, and optimizing quality of life for patients with LCL injuries.