Review Question - QID 107587

The 45-year-old male presents with laxity present on vargus stress test in his right knee with negative Lachman's and posterior drawer tests. Due to the effusion and swelling along with the mechanism of injury, this is most likely a tear of the lateral collateral ligament (LCL) along with a tear of the meniscus (positive McMurray's test).

A male that is hit on the medial aspect of his knee faces a varus force that causes damage to the LCL. In this setting, the patient has an effusion and swelling, so this is most likely a tear of the LCL instead of a sprain. Patients with LCL tears may experience some instability of the knee along with pain with activity. They can also present with effusion and swelling, though less commonly than those with ACL or MCL tears.

Grover et al. discuss evaluating knee injuries in patients on an outpatient basis. They state that when concerned about obtaining imaging to diagnose knee injuries with unclear physical exam signs, the Ottawa knee rules may be useful. Patients older than 55 who are unable to bear weight, flex their knees beyond 90 degrees, or have tenderness over the fibula or patella should be evaluated using at least a radiograph.

Latimet et al. performed a retrospective review of LCL reconstructions using the patellar tendon, and discovered that LCL reconstructions through this procedure achieved successful reduction in knee instability and reduced varus laxity and external rotation. Patients were also successful in being more active after reconstruction as indicated by improved clinical outcome scores.

Incorrect Answers:
Answer 1 and 2: Anterior cruciate and posterior cruciate ligament injuries would present with positive Lachman's and posterior drawer tests, respectively.
Answer 3: Medial collateral ligament injuries would present with a laxity on the valgus stress test.
Answer 5: Medial patellofemoral ligament tears result in patellar instability and are a major cause of recurrent patellar dislocations.