Fibular collateral ligament

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Lateral collateral ligament
Gray348.png
Left knee-joint, posterior aspect, showing interior ligaments. (Fibular collateral ligament labeled at center left.)
Details
From Lateral epicondyle of the femur
To Head of the fibula
Identifiers
Latin ligamentum collaterale fibulare, ligamentum collaterale laterale
TA98 A03.6.08.011
TA2 1895
FMA 9660
Anatomical terminology

The lateral collateral ligament (LCL, long external lateral ligament or fibular collateral ligament) is an extrinsic ligament of the knee located on the lateral side of the knee. [1] [ verification needed ] [2] Its superior attachment is at the lateral epicondyle of the femur (superoposterior to the popliteal groove); its inferior attachment is at the lateral aspect of the head of fibula (anterior to the apex). The LCL is not fused with the joint capsule. Inferiorly, the LCL splits the tendon of insertion of the biceps femoris muscle. [2]

Contents

Structure

The LCL measures some 5 cm in length. [2] It is rounded, and is more narrow and less broad compared to the medial collateral ligament. It extends obliquely inferoposteriorly from its superior attachment to its inferior attachment. [1] [ verification needed ]

In contrast to the medial collateral ligament, it is not fused with either the capsular ligament nor the lateral meniscus. [3] Because of this, the LCL is more flexible than its medial counterpart, and is therefore less susceptible to injury. [1] [ verification needed ]

Relations

Immediately below its origin is the groove for the tendon of the popliteus.[ citation needed ]

The greater part of its lateral surface is covered by the tendon of the biceps femoris; the tendon, however, divides at its insertion into two parts, which are separated by the ligament.[ citation needed ]

Deep to the ligament are the tendon of the popliteus, and the inferior lateral genicular vessels and nerve.[ citation needed ]

Function

Both collateral ligaments are taut when the knee joint is in extension. With the knee in flexion, the radius of curvatures of the condyles is decreased and the origin and insertions of the ligaments are brought closer together which make them lax. The pair of ligaments thus stabilize the knee joint in the coronal plane. Therefore, damage and rupture of these ligaments can be diagnosed by examining the knee's stability in the mediolateral axis. [1] [ verification needed ]

Clinical significance

Causes of injury

The LCL is usually injured as a result of varus force across the knee, [4] which is a force pushing the knee from the medial (inner) side of the joint, causing stress on the outside. An example of this would be a direct blow to the inside of the knee. The LCL can also be injured by a noncontact injury, such as a hyperextension stress, again causing varus force across the knee. [4]

An LCL injury usually occurs simultaneously as the other ligaments of the knee are injured. Multiple knee ligament tears and stresses can result from a significant trauma that includes direct blunt force to the knee, such as an automobile crash. [4]

Symptoms

Symptoms of a sprain or tear of the LCL includes pain to the lateral aspect of the knee, instability of the knee when walking, swelling and ecchymosis (bruising) at the site of trauma. Direct trauma to the medial aspect of the knee may also affect the peroneal nerve, which could result in a foot drop or paresthesias below the knee which could present itself as a tingling sensation. [4]

Treatment

An isolated LCL tear or sprain rarely requires surgery. If the injury is a Grade 1 or Grade II, microscopic or partial macroscopic tearing respectively, [4] the injury is treated with rest and rehabilitation. Ice, electrical stimulation and elevation are all methods to reduce the pain and swelling felt in the initial stages after the injury takes place. Physical therapy focuses on regaining full range-of-motion, such as biking, stretching and careful applications of pressure on the joint. Full recovery of Grade I or Grade II tears should take between 6 weeks and 3 months. Continued pain, swelling and instability to the joint after this time period may require surgical repair or reconstruction to the ligament. [5]

Additional images

See also

Related Research Articles

<span class="mw-page-title-main">Human leg</span> Lower extremity or limb of the human body (foot, lower leg, thigh and hip)

The leg is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or buttock region. The major bones of the leg are the femur, tibia, and adjacent fibula. The thigh is between the hip and knee, while the calf (rear) and shin (front) are between the knee and foot.

<span class="mw-page-title-main">Knee</span> Leg joint in primates

In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia, and one between the femur and patella. It is the largest joint in the human body. The knee is a modified hinge joint, which permits flexion and extension as well as slight internal and external rotation. The knee is vulnerable to injury and to the development of osteoarthritis.

<span class="mw-page-title-main">Hamstring</span> Any of the three tendons in the thigh

In human anatomy, a hamstring is any one of the three posterior thigh muscles between the hip and the knee.

<span class="mw-page-title-main">Tibia</span> Leg bone in vertebrates

The tibia, also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates ; it connects the knee with the ankle. The tibia is found on the medial side of the leg next to the fibula and closer to the median plane. The tibia is connected to the fibula by the interosseous membrane of leg, forming a type of fibrous joint called a syndesmosis with very little movement. The tibia is named for the flute tibia. It is the second largest bone in the human body, after the femur. The leg bones are the strongest long bones as they support the rest of the body.

<span class="mw-page-title-main">Patella</span> Kneecap, bone covering knee joint

The patella, also known as the kneecap, is a flat, rounded triangular bone which articulates with the femur and covers and protects the anterior articular surface of the knee joint. The patella is found in many tetrapods, such as mice, cats, birds and dogs, but not in whales, or most reptiles.

<span class="mw-page-title-main">Fibula</span> Leg bone in vertebrates

The fibula or calf bone is a leg bone on the lateral side of the tibia, to which it is connected above and below. It is the smaller of the two bones and, in proportion to its length, the most slender of all the long bones. Its upper extremity is small, placed toward the back of the head of the tibia, below the knee joint and excluded from the formation of this joint. Its lower extremity inclines a little forward, so as to be on a plane anterior to that of the upper end; it projects below the tibia and forms the lateral part of the ankle joint.

<span class="mw-page-title-main">Popliteal artery</span> Continuation of the femoral artery that supplies the lower leg

The popliteal artery is a deeply placed continuation of the femoral artery opening in the distal portion of the adductor magnus muscle. It courses through the popliteal fossa and ends at the lower border of the popliteus muscle, where it branches into the anterior and posterior tibial arteries.

The biceps femoris is a muscle of the thigh located to the posterior, or back. As its name implies, it consists of two heads; the long head is considered part of the hamstring muscle group, while the short head is sometimes excluded from this characterization, as it only causes knee flexion and is activated by a separate nerve.

<span class="mw-page-title-main">Adductor magnus muscle</span> Muscle in the thigh

The adductor magnus is a large triangular muscle, situated on the medial side of the thigh.

The semimembranosus muscle is the most medial of the three hamstring muscles in the thigh. It is so named because it has a flat tendon of origin. It lies posteromedially in the thigh, deep to the semitendinosus muscle. It extends the hip joint and flexes the knee joint.

<span class="mw-page-title-main">Semitendinosus muscle</span> One of the hamstring muscles; posterior part of the thigh

The semitendinosus is a long superficial muscle in the back of the thigh. It is so named because it has a very long tendon of insertion. It lies posteromedially in the thigh, superficial to the semimembranosus.

<span class="mw-page-title-main">Popliteus muscle</span> Muscle responsible for unlocking the knees during walking

The popliteus muscle in the leg is used for unlocking the knees when walking, by laterally rotating the femur on the tibia during the closed chain portion of the gait cycle. In open chain movements, the popliteus muscle medially rotates the tibia on the femur. It is also used when sitting down and standing up. It is the only muscle in the posterior (back) compartment of the lower leg that acts just on the knee and not on the ankle. The gastrocnemius muscle acts on both joints.

<span class="mw-page-title-main">Medial meniscus</span> Cartilage formation in the human knee

The medial meniscus is a fibrocartilage semicircular band that spans the knee joint medially, located between the medial condyle of the femur and the medial condyle of the tibia. It is also referred to as the internal semilunar fibrocartilage. The medial meniscus has more of a crescent shape while the lateral meniscus is more circular. The anterior aspects of both menisci are connected by the transverse ligament. It is a common site of injury, especially if the knee is twisted.

<span class="mw-page-title-main">Lateral meniscus</span>

The lateral meniscus is a fibrocartilaginous band that spans the lateral side of the interior of the knee joint. It is one of two menisci of the knee, the other being the medial meniscus. It is nearly circular and covers a larger portion of the articular surface than the medial. It can occasionally be injured or torn by twisting the knee or applying direct force, as seen in contact sports.

The knee examination, in medicine and physiotherapy, is performed as part of a physical examination, or when a patient presents with knee pain or a history that suggests a pathology of the knee joint.

<span class="mw-page-title-main">Posterior compartment of thigh</span> One of the fascial compartments that contains the knee flexors and hip extensors

The posterior compartment of the thigh is one of the fascial compartments that contains the knee flexors and hip extensors known as the hamstring muscles, as well as vascular and nervous elements, particularly the sciatic nerve.

<span class="mw-page-title-main">Knee bursae</span>

The knee bursae are the fluid-filled sacs and synovial pockets that surround and sometimes communicate with the knee joint cavity. The bursae are thin-walled, and filled with synovial fluid. They represent the weak point of the joint, but also provide enlargements to the joint space. They can be grouped into either communicating and non-communicating bursae or, after their location – frontal, lateral, or medial.

The arcuate popliteal ligament is an Y-shaped extracapsular ligament of the knee. It is formed as a thickening of the posterior fibres of the joint capsule of the knee. It reinforces the knee joint capsule inferolaterally.

Posterolateral corner injuries of the knee are injuries to a complex area formed by the interaction of multiple structures. Injuries to the posterolateral corner can be debilitating to the person and require recognition and treatment to avoid long term consequences. Injuries to the PLC often occur in combination with other ligamentous injuries to the knee; most commonly the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). As with any injury, an understanding of the anatomy and functional interactions of the posterolateral corner is important to diagnosing and treating the injury.

<span class="mw-page-title-main">Medial knee injuries</span> Medical condition

Medial knee injuries are the most common type of knee injury. The medial ligament complex of the knee consists of:

References

  1. 1 2 3 4 Thieme Atlas of Anatomy: General Anatomy and Musculoskeletal System. Thieme. 2006. pp. 393–395. ISBN   1-58890-419-9.
  2. 1 2 3 Palastanga, Nigel; Soames, Roger (2012). Anatomy and Human Movement: Structure and Function. Physiotherapy Essentials (6th ed.). Edinburgh: Churchill Livingstone/Elsevier. pp. 309–310. ISBN   978-0-7020-3553-1.
  3. Platzer, Werner (2004). Color Atlas of Human Anatomy, Vol. 1: Locomotor System (5th ed.). Thieme. p. 206. ISBN   3-13-533305-1.
  4. 1 2 3 4 5 Ho, MD, Sherwin SW. "Lateral Collateral Knee Ligament Injury". WebMD LLC. Retrieved 21 October 2012.
  5. Houston Methodist Orthopedics & Sports Medicine. "Lateral Collateral Ligament Injuries". Houston Methodist Hospital. Retrieved 11 December 2014.