Rehabilitation After Medial Collateral Ligament Repair: What You Need to Know

Is rehabilitation necessary after medial collateral ligament (MCL) repair surgery?

Hello, Director.
I suffered an accident last year that resulted in a rupture of the medial collateral ligament (MCL) and the anterior cruciate ligament (ACL).
I have since undergone surgery for the MCL repair, and it has been two weeks since the stitches were removed.
The doctor did not provide any rehabilitation instructions and only adjusted the angle of the brace.
However, I found information online regarding postoperative recovery for the ACL but not for the MCL.
I would like to ask:
1.
Is rehabilitation currently unnecessary? When can I put weight on my leg? When can I start walking on the affected limb?
2.
If rehabilitation is needed, when should it begin, and what should it involve?
3.
The doctor mentioned that the MCL should be addressed first before considering the ACL issue.
During the surgery, the arthroscopy revealed that a small portion of the ACL was still intact, and it was suggested that no further surgery was needed.
If the ACL is not repaired, will there be a higher risk of knee damage as I age?
I look forward to and appreciate your answers, Director!

Ou Di, 40~49 year old female. Ask Date: 2010/03/19

Dr. Shi Guozheng reply Orthopedics

The purpose of rehabilitation is to increase the strength of the leg or knee joint, as well as to enhance its range of motion.
Typically, rehabilitation can begin six weeks post-surgery.
If the anterior cruciate ligament is only partially torn and stability is sufficient, surgery may not be necessary.
However, if it is completely torn and not repaired, there is a potential risk of early degeneration, leading to arthritis in the future.

Reply Date: 2010/03/19

More Info

Rehabilitation after a medial collateral ligament (MCL) repair is crucial for restoring function and preventing long-term complications. Given your situation, where you have undergone surgery for both the MCL and anterior cruciate ligament (ACL), it's important to follow a structured rehabilitation plan to ensure optimal recovery.

1. Need for Rehabilitation: Even if your doctor has not explicitly recommended rehabilitation, it is generally advisable to start a rehabilitation program after MCL repair. Rehabilitation helps regain strength, flexibility, and function in the knee joint. You should consult with your orthopedic surgeon or a physical therapist to discuss your specific case and determine the best course of action. Typically, you can begin gentle range-of-motion exercises soon after surgery, but weight-bearing activities may be restricted initially.

2. When to Start Rehabilitation: Rehabilitation usually begins within a few days post-surgery, focusing on passive and active range-of-motion exercises. You may be able to start partial weight-bearing activities around 2-4 weeks post-surgery, depending on your pain levels and the surgeon's recommendations. Full weight-bearing may be allowed around 6-8 weeks post-surgery, but this varies based on individual healing and the extent of the injury.

3. Rehabilitation Protocol: A typical rehabilitation program for MCL repair includes:
- Phase 1 (Weeks 1-2): Focus on reducing swelling and pain. Gentle range-of-motion exercises should be performed. You may use ice and elevation to manage swelling.

- Phase 2 (Weeks 3-6): Gradually introduce weight-bearing activities as tolerated. Continue range-of-motion exercises and begin strengthening exercises for the quadriceps and hamstrings.

- Phase 3 (Weeks 6-12): Increase the intensity of strengthening exercises and begin functional activities like walking and light sports-specific drills.

- Phase 4 (3 months and beyond): Focus on sport-specific training and return to full activity, including agility and plyometric exercises.

4. Concerns about ACL: If your ACL is partially intact and your doctor has advised against surgical intervention, it is essential to monitor your knee's stability and function. While some individuals can function well without an ACL repair, others may experience instability, especially during activities that involve pivoting or sudden changes in direction. Over time, if the knee becomes unstable, it could lead to increased wear and tear on the cartilage and other structures, potentially resulting in osteoarthritis. Regular follow-ups with your orthopedic surgeon are vital to assess the knee's condition and determine if surgical intervention may be necessary in the future.

5. Long-term Considerations: As you age, the risk of knee injuries and degenerative changes may increase, particularly if the knee lacks proper stability. Engaging in a consistent rehabilitation program, maintaining a healthy weight, and participating in low-impact activities can help mitigate these risks.

In summary, while your doctor may not have prescribed a formal rehabilitation program, it is generally beneficial to engage in a structured rehabilitation process after MCL repair. Consult with a physical therapist to develop a personalized plan that considers your specific needs and goals. Regular follow-ups with your orthopedic surgeon will also help monitor your progress and address any concerns regarding your ACL and overall knee health.

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