MCL Part II

MCL Part III

Non-operative care:

Preferred treatments for isolated ACL injuries.  Multiple research studies indicate that non-operative care is has had as good or better result than surgery for isolated MCL injuries.

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Protocol: Goal Orientated rehabilitation program for isolated MCL sprains

Initial:

 -Ice
 -Lateral hinge brace
 -Weight-bearing as tolerated

Subsequent:

 -Begin ROM exercises in whirlpool
 -SLR

Goal One: Walking without a limp

  -D/C crutches
  -Isometric strengthening, and conditioning exercises

Goal two: 90Degrees of knee flexion

 -Begin stair climber and bike with low resistance building higher
 -Isotonic and isokinetic quad and hamstring strengthening

Goal Three: Full knee ROM

 -Begin running and functional exercises
 -Begin agility drills

Goal Four: Complete entire running program in one session

 -jog 1 mile
-100 yard sprint ½ speed
 -100 yard sprint ¾ speed
 -100 yard sprint full speed

 

Probable surgery indication for medial sided injuries

Acute repair

-Intraarticular ligamentous entrapment
-A large boney avulsion
-Tibial platue fracture
 -Presence of anterior medial rotary instability
 -Underlying valgus knee malalignment

Delayed repair

-Combined ACL injury

 

Post-operative Precautions

-Non-weight-bearing for 3weeks in brace that allows 30-90 degrees of flexion
 -3 weeks patient is allowed to do full ROM to tolerance
 -At 6 week, progressive strengthening activities are started