Collateral Ligaments and other non-cruciate tendons & ligaments around the knee :
plc or lcl damage - - Posted by builder_bob (builder_bob), 28 September 2004
in january i fell on 3rd day skiing hurt a little but skied down the mountain and skied out the holiday with no problem at all. had some pain in knee when i got home so after 3 months went to see specialist in sheffield Mr Bickerstaff had mri and he said torn acl and plc(lcl) damage but plc damage did not show on mri but this was his opinion my knee seems fine very little pain or instability and i am a builder so its always under pressure i find it hard to understand! i would like to know ifthe plc will get better or do i really need acl andplc done as i have heard the plc has not a great success rate!please help 
Posted by Philip (Philip), 29 September 2004
Hey Bob,
that sounds rather strange. I completely ripped my ACL and my LCL and loads of tendons as well (itband and biceps femoris tendon). However, there was no way I could have moved - let alone put any weight on it - you could take my (injured right) leg - hold the femur tight and bend it 30 degrees to the left. I was treated as a A&E case in Scotland and was operated a week after my accident. Initially they thought I ripped my PCL as well however it turned out to be merely strained and did not need a reconstruction.
So I found it very hard to believe that you ripped three ligaments and continued skiing and working!!! So, probably your PCL is (hopefully) merely strained just as mine was, and your LCL probably as well (well I am not a doctor but just in comparison to my experience I would be very surprised if they were ripped and needed reconstrucrtion....)
I think there is nothing much you can do if the PCL is merely strained. My doctor just left the PCL and after 6 weeks tested the stability of my knee and was really happy how stable it was - the PCL is absolutely fine now and the reconstructed ligament is healing well. I am 5 hand a half months post - back into jogging and have hardly any problems at the moment. I am training my leg though pretty much every day and hope to get back to full sports 12 months post op. My physio and surgeon are both very happy with it so don't be worried such injuries can be overcome.
Well keep us updated and maybe let someone else have a look at the MRI's....
Cheers,
Philip
Posted by builder_bob (builder_bob), 29 September 2004
thanks for reply philip my typing is not to good so you may have misunderstood my message. i only injured my acl and lcl not pcl. as you say though i cant understand how i had little pain and one more thing i didnt mention my knee swelled very little.i have very little instability and i am at the gym 3 times a week! could the surgeon be wrong he has a good record so should i trust him i just dont know. this knee business is very confusing and expensive when you are paying private thanksagain for replying bob
Posted by cgski (cgski), 29 September 2004
Don't know whether this helps, but a colleague of your os, who I saw privately (£££s) diagnosed ruptured acl (reattached to pcl for good measure) - along with mcl tear and meniscal damage (also a ski job) - from mri scan and examination.
However, recently had an arthroscopy (on the nhs) - which found no damage to the acl at all - so just tidied up the meniscus and mcl.
My injury wasn't painful either - and didn't swell very much - tho I truly could not ski at all (knee totally unstable - I tried - I soo wanted to ski) - and the ski doc diagnosed acl/mcl/meniscal tears too right after the accident.
Does this help? cgski
Posted by Philip (Philip), 30 September 2004
Bob,
do you have any instability on your lateral side? That is can you bend the tibia towards the other leg - stretching your (presumably ripped) LCL. Apparantely, the LCL provides a fair amount of stability and if you say there is not much instability then it might be there is not much wrong with the LCL...as mentioned, my tibia was just dangling off my leg and I could hardly control it having two ligaments torn.
Well, it might be worth checking another surgeon in your area...all the best and keep us posted on any news!
Cheers,
Philip
Posted by builder_bob (builder_bob), 30 September 2004
i am really glad i found this site after the replies i have had.cgski i am very interested to hear that you saw a colleague of my os and yes it was big bucks just for my mri and consultation. the more i hear the more i am very unsure of my injury, it just does not seem to be the norm the way it has reacted after my fall. after you had your fall how long was it before you had no pan did it go on for months?
philip i have very little movment laterally am just baffled the only symptom i seem to get is clicking in my knee joint and very slight pain if i twist my knee. i have seen a physio and he does not agree at all with the os he worked for bodyfactor at snow and rock and he says he has lots of experience with ski injuries. when i read some of the messages mine just seems to be nothing at all as serious as any i have seen how bizarre!!
Posted by wimple (wimple), 30 September 2004
Hi,
Don't know if this will help, I have clicking in my knee and pain, though it is all the time and not just when I twist. My physio feels that I have sprained the lcl, perhaps this is something you need to investigate through a referal from your gp or perhaps find a physio (like the one you have seen) who specialises in sports injuries and can give you some idea how to proceed with this, as it may be a case of doing appropriate exercises etc to get your knee back to normal. Hope you get some answers soon. Also, its possible that you have torn one of your ligaments, but even with a grade 1 (very minor) tear to my mcl when I orginally injured my knee I was in a lot of pain. If you're not getting acute pain and instability I'd definitely seek a second opinion
Posted by builder_bob (builder_bob), 30 September 2004
thanks for suggestion wimpole will ask physio and maybe try through my gp. yousay you have pain all the time i have a little pain but not all the time when i stretch my leg i get a twinge in the lcl like its stretching too much and sometimes a little pain just under the patella there is definately something not quite right but i am just so unsure if its the acl and lcl gone as i have been led to believe. thanks for your help.
Posted by cgski (cgski), 1 October 2004
Just to follow up on your questions, Bob: I hurt my leg in Feb this year. It still feels a little weird now - but this seems to be because of the way the muscles just wasted away - I had a full leg cast for a few weeks, followed by a brace, set initially at just 40 degrees rom for a couple of months after that.
I did all my physio religiously! - (tho it all seemed a bit tame to me) and tried to be pretty active - esp over the summer - (lots of long hikes, bit of back packing and scrambling mountains) - but as my os pointed out the other week, my quads and hamstrings on the duff leg are about 1/3 the size of the good leg - so am now following his advice to get to the gym and really work on building the muscles - the killer for me is the exercise bike, duff leg only. I can't help wondering how many others think it's the knee that's the problem, when it's really the after effects of being immobilised. It was not something that any os had looked at until last week.
I was really glad to get the arthroscopy done - because it gave a definitive answer on the injury, as well as giving the injured bits and pieces a clean up. The (nhs) os was adament that he was going to look before making any decisons on what to do - ie I knew he wasn't going to do any really major works. This meant he was able to fit me in quickly.
Hoping this helps! cgski
PS The private os also diagnosed damage my plc - (didn't know what the acronym stood for at the time) - never did beleive this - it was big tick, fine when looked at in the arthroscopy.
Posted by builder_bob (builder_bob), 4 October 2004
cgski seems like you have had a rough time in the last year! My injury was in Feb too. Seems like some of the diagnosis people get from the mri scan can be inaccurate or is it the way they are interpreted? i have been at the gym quite alot and have decided too really push the knee and see how it goes its a littlte sore but doesnt feel bad physio is pleased with progress and is very convinced that my knee fine that is apart from the clicks which as a builder and being on my knees alot is quite normal. have got a skiing holiday booked for feb again and i intend to make it .I am strenghtening my legs especially hamstrings and calves quads are not too bad physio says this will help the knee alot. thanks for your help i am really pleased you answered my message as you have had a similar experience to me.I will let you know how i get on. Bob
Posted by cgski (cgski), 5 October 2004
B-B Did you see the message I sent?? Check out the top right hand of your screen if not... cgski
Posted by andrewc (AndrewC), 6 October 2004
Hey cgski
Good to hear your ACl is fine after all that.....talk about a misdiagnosis by that consultant 
Builder_bob
Your injury/diagnosis seems really strange! As Philip said if you had done the injury you have been told you did then it would normally have caused big pain/problems....
Also, a meniscal tear could cause exactly the symptoms you talk of....though it seems you havent been diagnosed with one??
Can cause stiffness in the knee if bent for a while....clicking in the joint (tho some people have naturally "clicky" knees with no meniscal damage)....and when injured they dont often cause a great deal of swelling or (usually) instability.
An ACL tear on the other hand would be expected to swell like a balloon!
As for the MRI...they can sometimes be misleading to the radiographer and resultantly be interpreted incorrectly.
All the best
Posted by grudier (grudier), 18 October 2004
Hello, my reply is mostly to Phillip, as our injuries are eerily similar. I tore my ACL, LCL, and PLC(which is pretty much the LCL), strained PCL, torn Illiotibial Band and torn Lateral Meniscus. I am very curious as to how they treated you, what type of grafts they used, did they cast you, any complications. I am almost 10 months post op, and like you I could bend my leg 30-40 degrees sideways. I had no stability at all. I'm doing well now, though my Hamstrings are lagging well behind. Let me know how you're doing.
Posted by builder_bob (builder_bob), 2 November 2004
thanks for lookin at the injury message andrew. i agree it does seem very strange especially wiht virtually no instability. my physio is adamant that their is very little wrong with the knee. and one thing i forgot to mention is that when the os did the examination pre mri scan he was convinced the acl was intact. i just think that as its giving me very little trouble maybe its best left alone. i will keep everyone posted and thanks again cos u've all helped 
Posted by kporterjud (kporterjud), 2 November 2004
I fell skiing about 16 years ago, knew I'd hurt something but after about 20 minutes was able to ski off under my own power and never sought treatment. Over the years, both knees have bothered me on & off, especially my right knee to the point where there were times that I could barely walk on it. A couple of years ago, after one of those weekly bouts of painfully hobbling around, I finally saw an OS. At the time, she advised weight loss (which I did lose about 25 lbs) exercise & prescribed PT. All that being done, (jump to the present) I work out regularly and eat a balanced diet. I started finding myself having difficulty kneeling and squatting to the point that I can't, because I may not get up. Even if I do I can't put any weight on the right knee/or leg from 1 - 2 hours. (And forget dancing.) I've finally gotten sick of it, saw my PCP, had xrays done and was referred to an OS, & got MRI done. Some things have shown up, but negative on torn meniscii or torn ligaments but MRIs have been known to miss a few things. Hey, your body doesn't hurt for no reason at all; it's saying "need a little help here"! So I'm going for an arthroscopy, 'cause that's the only was they can get a completely good look at what's going on. My 2 cents or sixpence? Do nothing and it will only get worse.
Posted by mike_motor (mike_motor), 4 January 2005
I''m pretty sure (not from medical background but real world experience) that if you had a torn ACL and LCL that you would have been in pain and would have instability.
I was in excruciating pain at the time of injuring. You have to think about what happens. Ligaments tear in half, others detach themselves from where they should be in the case of the LCL and its place in the post lateral corner (PLC). My LCL torn and basically rolled up into a little ball on the lower outside of my knee. Felt like a little rubber ball underneath the skin.
All that stuff is trauma that causes bleeding, inflamation, and pain. If you've just strained some ligaments, you could still be walking, working, etc. but in my opinion, if you tore them you'd know it , especially the ACL/LCL combo, because supposedly it is the worst for stability.
While waiting for surgery I walked around with a knee brace and if I stepped on a golf ball sized rock my knee wobbled and popped.
Just some info for you. I guess everyone's body is different but with that much injury I'd think there would be pain and instability just from the pure nature of what actually happens inside your knee.
Updated Sat Nov 21 2009
