OVERVIEW
The knee joint is the second injury-prone joint in athletes, after the ankle. Paying close attention to the movement of the body, it contains ligaments that connect the femur with the bones of the tibia, the fibula and the patella. Although these ligaments are made to withstand stress, however, sprains are very common; especially in soccer, basketball and skiing, injuries to the medial collateral ligament are very common.
We are talking one of the most important ligaments for knee stability, as it strengthens its inner side and protects the joint from valgus movements, namely, the dislocation of tibia towards the outside, in relation to the thigh. A direct, high-impact blow on the outside of the knee that results in its “pushing” towards the inside (towards the other knee) is the most common injury mechanism for the rupture of the medial collateral ligament. It is also likely to happen from a fall or a sudden change of direction with the sole stuck to the ground - the players are injured during the sliding tackle. It is often accompanied by other injuries, often in the anterior cruciate ligament.

WHICH ARE THE SYMPTOMS?
Depending on the severity of the injury (simple, partial or total rupture), blood may be accumulated in the joint (hemarthrosis) while the knee is unable to fully extend and flex. Pain is mainly located on the inner surface of the joint, walking is difficult, and instability is observed in chronic cases.

WHICH IS THE BEST TREATMENT?
Diagnosis is made through the obtaining of a full history and specific clinical tests, to assess the extent of the damage. An MRI shall confirm the diagnosis and will show if there are any additional injuries. Depending on the severity of the rupture and functional requirements of the patient, the treatment may be conservative or surgical.
In cases where the ligament has been partially ruptured, and hence can heal itself, it is proposed to apply a functional splint, ice therapy, physical therapies and strengthening exercises. The return to sports activities takes about 2 months. Still, even in cases of a total rupture, conservative treatment may be applied, but recovery may take up to 4 months.
In patients with a total rupture, or those who conservative treatment fails, resulting in knee instability, but also those with increased functional requirements, direct surgical treatment is recommended. If the injury is recent, the ligament is sutured or reattached. In chronic cases, the reconstruction of the ligament is performed using an autograft, obtained from the patient themselves. The return to sports activities is estimated at 2 months, depending on the type of surgery and the concomitant lesions which were treated at the same time.

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