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CONDITION/DISORDER SYNONYM

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  • Tibial collateral ligament sprain

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ICD-9-CM CODE

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  • 844.1 Sprain of medial collateral ligament of knee

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ICD-10-CM CODE

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  • S83.419A Sprain of medial collateral ligament of unspecified knee, initial encounter

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PREFERRED PRACTICE PATTERNS

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  • 4D: Impaired joint mobility, motor function, muscle performance, and range of motion (ROM) associated with connective tissue ­dysfunction

  • 4E: Impaired joint mobility, motor function, muscle performance, and ROM associated with localized inflammation

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PATIENT PRESENTATION

A 24-year-old male presents with right medial knee pain following an injury during a recreational flag football game 2 days ago. The patient reports a player fell on the outside of his right leg while he was blocking another player. He felt immediate knee pain but did not hear an audible pop. Since the injury he reports mild to moderate swelling and pain with fully extending or fully bending his knee, getting his legs out of the car, and going from supine to sit in his bed, especially to the left. The patient denies clicking or popping, but does report a slight feeling of giving away on occasion with changing directions while walking. On physical examination there is tenderness over the medal aspect of the knee. Range of motion is full but painful at end range flexion and extension. Lachman’s test is negative and valgus stress testing is positive on the right for pain with 1+ laxity and a firm end feel.

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KEY FEATURES

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Description
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  • Tear of the medial collateral ligament of the knee

  • May be graded based on extent of damage1,2

    • Grade I: Localized tenderness with no instability

    • Grade II: Localized tenderness, moderate fiber disruption; slight to moderate abnormal motion

    • Grade III: Complete fiber disruption; noted instability

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Essentials of Diagnosis
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  • Injury is generally traumatic and can occur at any age.

  • Trauma is usually a high impact force applied to the lateral knee.

  • The anterior cruciate ligament (ACL) and medial meniscus are commonly injured concurrently.

  • Clinical diagnosis is generally made through history of injury and knee valgus stability testing.

  • Diagnosis may be confirmed with magnetic resonance imaging (MRI).

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General Considerations
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  • Medial collateral ligament is most taut in knee extension.

  • Commonly injured from an outside force hitting the lateral portion of the knee, that is football tackle.

  • Anterior fibers of superficial band is taut with flexion.2

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FIGURE 194-1

(A) Anterior and (B) lateral views of knee joint showing ligaments. (From Hamilton N, Weimar W, Luttgens K. Kinesiology: Scientific Basis of Human Motion. 11th ed. http://www.accessphysiotherapy.com. Copyright © McGraw-Hill Education. All rights reserved.)

Graphic Jump Location
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Demographics
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  • Most commonly injured ...

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