Last reviewed: March 2020
Last updated: December  2019

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • injury due to excessive or repetitive valgus loading of MCL
  • medial knee pain
  • joint effusion
  • tenderness
  • laxity on valgus stress testing

Other diagnostic factors

  • ecchymosis
  • audible pop or tearing sensation at time of injury
  • difficulty walking
  • instability symptoms of knee
  • mechanical knee symptoms
  • knee deformity
  • positive anterior drawer test
  • positive posterior drawer test
  • positive Lachman's test
  • positive pivot shift test
  • joint line tenderness
  • chronic pain

Risk factors

  • participation in activities involving valgus stress at the knee joint
  • age 20 to 35 years
  • age 55 to 70 years
  • weak muscles that cross the medial aspect of knee

Diagnostic investigations

Treatment algorithm

Contributors

Sanjeev Bhatia

Co-Director, Hip & Knee Joint Preservation Center

Northwestern Medicine Central DuPage Hospital

Northwestern University Feinberg School of Medicine

Warrenville

IL

Disclosures

SB receives royalties from the following Nova publication: Ligamentous Injuries of the Knee. SB has stock ownership in Vericel and Joint Preservation Innovations, LLC.

Nikhil N. Verma

Professor

Department of Orthopedic Surgery

Section of Sports Medicine

Rush University Medical Center

Chicago

IL

Disclosures

NNV declares the following competing interests: American Orthopaedic Society for Sports Medicine: board or committee member; American Shoulder and Elbow Surgeons: board or committee member; Arthrex, Inc.: research support; Arthroscopy: publishing royalties, financial or material support; Arthroscopy Association of North America: board or committee member; Breg: research support; Cymedica: stock or stock options; Knee: editorial or governing board; Minivasive: paid consultant, stock or stock options; Omeros: stock or stock options; Orthospace: paid consultant; Ossur: research support; SLACK Incorporated: editorial or governing board; Smith & Nephew: IP royalties, research support; Vindico Medical-Orthopedics Hyperguide: publishing royalties, financial or material support; Wright Medical Technology, Inc.: research support. 

Peer reviewersVIEW ALL

Co-director of Orthopedic Sports and Shoulder Service

Department of Orthopedic Surgery

Naval Medical Center San Diego

San Diego

CA

Disclosures

DJS declares that he has no competing interests.

Professor

Chief of Physical Medicine and Rehabilitation

Ann Arbor VA Medical Center

Ann Arbor

MI

Disclosures

RW has been reimbursed by the University of Michigan for attending several conferences and has been paid an honorarium for speaking at the American Association of Neuromuscular and Electrodiagnostic Medicine national meeting. RW has been paid by the National Institute for Occupational Safety and Health, the American Dental Association, and SmartHealth as a consultant and has received grant funding from the UAW/GM Health and Safety Board (over US$1 million).

Assistant Director

Orthopaedic Shoulder and Sports Surgery

Naval Medical Center San Diego

San Diego

CA

Disclosures

MTP declares that he has no competing interests.

Clinical Assistant Professor of Medicine

Robert Wood Johnson Medical School

University of Medicine and Dentistry of New Jersey

Piscataway

NJ

Disclosures

PHC declares that he has no competing interests.

Orthopedic Surgeon

Department of Orthopedic Surgery

Seoul Veterans Hospital

Seoul

South Korea

Disclosures

JRY declares that she has no competing interests.

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