Lateral Collateral Ligament Reconstruction (LCL)
A surgical procedure to repair and stabilise the outer ligament of the knee
The LCL is one of the main stabilising ligaments of the knee, connecting the femur (thighbone) to the fibula (the smaller bone of the lower leg). Injuries to the LCL often occur due to trauma, such as a direct blow to the inner side of the knee or during activities that involve sharp directional changes.
Common Reasons for LCL Reconstruction Surgery
- Complete or severe LCL tears that have not healed with non-surgical treatments.
- Chronic knee instability, causing pain or difficulty performing daily activities.
- Combined ligament injuries, such as ACL or PCL tears, requiring comprehensive knee reconstruction.
The goals of LCL reconstruction are to stabilise the knee, reduce pain, and restore functional movement.
Preparation for Surgery
A comprehensive evaluation by Dr Ben McGrath is essential to plan the procedure. Imaging studies such as X-rays, MRIs, or CT scans are used to assess the severity of the injury and determine the most appropriate surgical approach.
Key Steps in Preparation:
- Consultation: Dr McGrath will discuss the procedure, its potential benefits and risks, and answer any questions.
- Pre-Surgical Instructions: Patients may need to fast before surgery and adjust medications, such as stopping blood thinners.
- Prehabilitation: Strengthening the muscles around the knee before surgery may improve recovery outcomes.
- Lifestyle Adjustments: Maintaining a healthy weight, ceasing smoking, and addressing any underlying health conditions may optimise results.
What Happens During the Surgery?
LCL reconstruction is typically performed under general anaesthesia using minimally invasive techniques where possible.
Surgical Steps:
- Incisions: Small incisions are made on the outer side of the knee to access the damaged ligament.
- Graft Preparation: A graft, often taken from the hamstring or a donor source, is prepared to replace the damaged LCL.
- Placement and Fixation: The graft is secured to the femur and fibula using screws or other fixation devices to restore ligament function.
- Closure: The incisions are closed with sutures or adhesive strips, and the knee is bandaged for protection.
The procedure typically takes 1 to 2 hours, depending on the complexity of the injury.
Understanding the Risks
While LCL reconstruction is generally safe, it is important to be aware of potential risks:
- Infection: At the incision sites or within the joint.
- Graft Failure: Rarely, the reconstructed ligament may not function as expected.
- Swelling and Stiffness: Temporary inflammation or reduced range of motion.
- Blood Clots: Rare but possible in the lower limbs.
- Nerve or Vessel Injury: Extremely rare but a potential risk during surgery.
Dr McGrath employs advanced surgical techniques and follows strict safety protocols to minimise these risks.
What to Expect After Surgery
Immediate Post-Operative Care:
- Pain Management: Mild to moderate discomfort can be managed with prescribed medications and regular icing.
- Assistive Devices: Crutches and a knee brace may be required to protect the reconstructed ligament during the initial recovery phase.
- Discharge Instructions: Patients will receive clear guidance on wound care, activity restrictions, and follow-up appointments.
Rehabilitation and Recovery
Recovery from LCL reconstruction involves a structured rehabilitation program tailored to the patient’s needs:
Phase 1: Early Recovery (Weeks 0–6)
- Goals: Protect the graft, reduce swelling, and restore range of motion (ROM).
- Activities: Partial weight-bearing with crutches, gentle ROM exercises, and cryotherapy.
Phase 2: Strength and Mobility (Weeks 6–12)
- Goals: Regain strength, stability, and mobility in the knee.
- Activities: Physiotherapy for strengthening the quadriceps and hamstrings, light cycling, and balance exercises.
Phase 3: Advanced Recovery (Months 3–6)
- Goals: Restore full function and prepare for daily activities or sports.
- Activities: Progressive resistance training, functional drills, and agility exercises.
Long-Term Outcomes
LCL reconstruction may help stabilise the knee, alleviate pain, and improve overall function. Long-term success depends on:
- Adherence to rehabilitation guidelines.
- Regular follow-up appointments to monitor progress.
- Maintaining a healthy lifestyle, including low-impact activities to support joint health.
Most patients experience significant improvements in knee stability and mobility, enabling them to resume their desired activities with confidence.