Lateral Collateral Ligament (LCL) repair or reconstruction is a surgical procedure that aims to address an injured LCL in the knee joint and restore its stability and function. The LCL is a major ligament which is situated on the lateral side of the knee and plays a crucial role in controlling the sideways movement of the knee joint.

Indications for Surgery

Surgery is typically considered in the following scenarios:Surgery is typically considered in the following scenarios:

1.     Complete LCL Tear: If the ligament is totally ruptured and conservative measures have not relieved the instability.

2.     Combined Injuries: If there are other ligament injuries in the knee or other structures such as ACL, PCL etc.

3.     Chronic Instability: Knee instability that remains chronic or flares up again even after having gone through proper physiotherapy.

4.     Athletic Demands: For athletes or highly active individuals who need functional knee movement for sports or other activities.

Types of Surgical Procedures

LCL Repair

·        Indication: Usually done when the injury is not very old and the ends of the ligament can be brought close together.

·        Procedure: The two ends of the ligament are sewn back together, possibly with the use of suture anchors or other forms of fixation.

·        Recovery: This option is used more often when there is good tissue quality and minimal retraction of the ligament ends.

LCL Reconstruction

·        Indication: Indications for ACL reconstruction include a complete tear of the ligament, poor quality tissue, or chronic instability.

·        Procedure: A graft which can be from the patient’s hamstring, patellar tendon or from a donor is used to repair the damaged ligament. The graft is then placed into drilled holes in the bones at the previous locations of the LCL attachment.

·        Recovery: This is a more comprehensive process than repair, which requires a longer period of rehabilitation.

Surgical Techniques

1.     Open Surgery: The conventional approach that involves making a big wound to directly work on the ligament to repair or reconstruct it.

2.     Arthroscopic Surgery: Laparoscopic method which involves making several small cuts on the body and using a camera to perform the surgery. This is less common for LCL injuries since the ligament is located in a different area.

Postoperative Care and Rehabilitation

·        Immobilization: The first phase of the treatment, which involves the use of a brace or cast to restrict movement of the affected part and enable it to heal.

·        Physical Therapy: Initiation with passive and active range of motion exercises, followed by muscle strengthening exercises. Therapy is essential to rehabilitate the affected area and bring it back to normal functioning.

·        Weight Bearing: Moderate at the beginning and then gradually increased as the healing process continues.

·        Return to Activity: In some cases, patients may be able to return to sports or high-impact activities within 6-12 months of the surgery.

Risks and Complications

·        Infection: Like any other surgery, there is always a possibility of infection.

·        Stiffness: Increased risk of knee stiffness if proper postoperative rehabilitation is not followed.

·        Graft Failure: Potential for graft to be stretched or fail especially in heavily involved people.

·        Nerve Injury: Damage to the nerves near the surgical site, causing numbness or muscle weakness.


The majority of patients have good to excellent results, and are able to regain their pre-injury functional status. The outcomes vary with factors like the extent of the injury, the type of surgery performed, and compliance with the recommended physiotherapy.

It is recommended to seek the opinion of an orthopedic surgeon who is a sports medicine specialist or has a special interest in knee injuries to establish the most appropriate management plan based on the patient’s specific case.