WordNet

situated or running side by side; "collateral ridges of mountains"
a security pledged for the repayment of a loan
serving to support or corroborate; "collateral evidence" (同)confirmative, confirming, confirmatory, corroborative, corroboratory, substantiating, substantiative, validating, validatory, verificatory, verifying
descended from a common ancestor but through different lines; "cousins are collateral relatives"; "an indirect descendant of the Stuarts" (同)indirect
accompany, concomitant; "collateral target damage from a bombing run"
any connection or unifying bond
a sheet or band of tough fibrous tissue connecting bones or cartilages or supporting muscles or organs
the inner and thicker of the two bones of the human leg between the knee and ankle (同)shinbone, shin_bone, shin
relating to or located near a tibia

PrepTutorEJDIC

並び合った / 二次的な,付随的な(secondary) / 証券類を担保とした / 傍系の,直系でない / 担保,低当,見返り物資
靱帯(じんたい)(骨と骨を結びつてけ関節の動きを調節する)
脛骨

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/02/17 09:29:36」(JST)

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The medial collateral ligament (MCL or tibial collateral ligament) is one of the four major ligaments of the knee. It is on the medial (inner) side of the knee joint in humans and other primates. Its primary function is to resist valgus forces on the knee.

Structure

It is a broad, flat, membranous band, situated slightly posterior on the medial side of the knee joint. It is attached proximally to the medial epicondyle of the femur immediately below the adductor tubercle; below to the medial condyle of the tibia and medial surface of its body. It resists forces that would push the knee medially, which would otherwise produce valgus deformity.

The fibers of the posterior part of the ligament are short and incline backward as they descend; they are inserted into the tibia above the groove for the semimembranosus muscle.

The anterior part of the ligament is a flattened band, about 10 centimeters long, which inclines forward as it descends.

It is inserted into the medial surface of the body of the tibia about 2.5 centimeters below the level of the condyle.

Crossing on top of the lower part of the MCL is the pes anserinus, the joined tendons of the sartorius, gracilis, and semitendinosus muscles; a bursa is interposed between the two.

The MCL's deep surface covers the inferior medial genicular vessels and nerve and the anterior portion of the tendon of the semimembranosus muscle, with which it is connected by a few fibers; it is intimately adherent to the medial meniscus.

Development

Embryologically and phylogenically, the ligament represents the distal portion of the tendon of adductor magnus muscle. In lower animals, adductor magnus inserts into the tibia. Because of this, the ligament occasionally contains muscle fibres. This is an atavistic variation.

Clinical significance

Injury

An MCL injury can be very painful and is caused by a valgus stress to a slightly bent knee, often when landing, bending or on high impact. It may be difficult to apply pressure on the injured leg for at least a few days.

The most common knee structure damaged in skiing is the medial collateral ligament, although the carve turn has diminished the incidence somewhat.^[1] MCL strains and tears are also fairly common in American football. The center and the guards are the most common victims of this type of injury due to the grip trend on their cleats, although sometimes it can be caused by a helmet striking the knee. The number of football players who get this injury has increased in recent years. Companies are currently trying to develop better cleats that will prevent the injury. MCL is also crucially affected in breaststroke and many professional swimmers suffer from chronic MCL pains.

Treatment

Depending on the grade of the injury, the lowest grade (grade 1) can take between 2 and 10 weeks for the injury to fully heal. Recovery times for grades 2 and 3 can take weeks to several months.

Treatment of a partial tear or stretch injury is usually conservative. Physical Therapy should be a first choice option for treatment and diagnosis of injuries to this structure. This includes measures to control inflammation as well as bracing. Kannus has shown good clinical results with conservative care of grade II sprains, but poor results in grade III sprains.^[2] As a result, more severe grade III and IV injuries to the MCL that lead to ongoing instability may require arthroscopic surgery. However, the medical literature considers surgery for most MCL injuries to be controversial.^[3] Isolated MCL sprains are common.

For higher grade tears of the MCL with ongoing instability, the MCL can be sutured or replaced. Other non-surgical approaches for more severe MCL injuries may include prolotherapy, which has been shown by Reeves in a small RCT to reduce translation on KT-1000 arthrometer versus placebo.^[4] The future of non-surgical care for a non-healing MCL injury with laxity (partial ligament tear) is likely bioengineering. Fan et al. (2008) have demonstrated that knee ligament reconstruction is possible using mesenchymal stem cells and a silk scaffold.^[5]

Additional Images

Anterior view of knee.

References

^ "KNEE INJURIES". www.ski-injury.com. Retrieved October 13, 2013. ^{[unreliable medical source?]}
^ Kannus, P (1988). "Long-term results of conservatively treated medial collateral ligament injuries of the knee joint". Clinical orthopaedics and related research (226): 103–12. doi:10.1097/00003086-198801000-00015. PMID 3335084.
^ Indelicato, P. A. (1995). "Isolated Medial Collateral Ligament Injuries in the Knee". The Journal of the American Academy of Orthopaedic Surgeons 3 (1): 9–14. PMID 10790648.
^ Reeves, K. D.; Hassanein, K (2000). "Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity". Alternative therapies in health and medicine 6 (2): 68–74, 77–80. PMID 10710805. ^{[unreliable medical source?]} Results should be contrasted with meta-analysis such as the one by Rabago et al: Rabago, D; Best, T. M.; Beamsley, M; Patterson, J (2005). "A systematic review of prolotherapy for chronic musculoskeletal pain". Clinical Journal of Sport Medicine 15 (5): 376–80. PMID 16162983. Lay summary – PubMed Health (April 30, 2007).
^ Fan, Hongbin; Liu, Haifeng; Wong, Eugene J.W.; Toh, Siew L.; Goh, James C.H. (2008). "In vivo study of anterior cruciate ligament regeneration using mesenchymal stem cells and silk scaffold". Biomaterials 29 (23): 3324–37. doi:10.1016/j.biomaterials.2008.04.012. PMID 18462787.

External links

lljoints at The Anatomy Lesson by Wesley Norman (Georgetown University) (antkneejointopenflexed)
Medial Collateral Ligament (MCL) Tears

UpToDate Contents

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1. 成人における急性膝痛の放射線評価 radiologic evaluation of the acutely painful knee in adults
2. 膝内側側副靱帯損傷 medial collateral ligament injury of the knee
3. Approach to acute knee pain and injury in children and skeletally immature adolescents
4. 外側側副靭帯損傷および関連する膝後外側支持機構損傷 lateral collateral ligament injury and related posterolateral corner injuries of the knee
5. 成人における膝痛の総合的評価 general evaluation of the adult with knee pain

English Journal

An improved OpenSim gait model with multiple degrees of freedom knee joint and knee ligaments.

Xu H1, Bloswick D, Merryweather A.
Computer methods in biomechanics and biomedical engineering.Comput Methods Biomech Biomed Engin.2015 Aug;18(11):1217-1224. Epub 2014 Mar 11.
Musculoskeletal models are widely used to investigate joint kinematics and predict muscle force during gait. However, the knee is usually simplified as a one degree of freedom joint and knee ligaments are neglected. The aim of this study was to develop an OpenSim gait model with enhanced knee struct
PMID 24611807

Surgical Techniques for the Reconstruction of Medial Collateral Ligament and Posteromedial Corner Injuries of the Knee: A Systematic Review.

DeLong JM1, Waterman BR2.
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.Arthroscopy.2015 Jul 17. pii: S0749-8063(15)00462-4. doi: 10.1016/j.arthro.2015.05.011. [Epub ahead of print]
PURPOSE: To systematically review reconstruction techniques of the medial collateral ligament (MCL) and associated medial structures of the knee (e.g., posterior oblique ligament).METHODS: A systematic review of Medline/PubMed Database (1966 to November 2013), reference list scanning and citation se
PMID 26194939

Surgical Repair of Medial Collateral Ligament and Posteromedial Corner Injuries of the Knee: A Systematic Review.

DeLong JM1, Waterman BR2.
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.Arthroscopy.2015 Jul 8. pii: S0749-8063(15)00461-2. doi: 10.1016/j.arthro.2015.05.010. [Epub ahead of print]
PURPOSE: To systematically evaluate surgical techniques and objective clinical outcomes of primary repair of the medial collateral ligament (MCL) and posteromedial corner of the knee.METHODS: A systematic review of the PubMed/Medline Database (1966 to August 2014) was performed to identify all clini
PMID 26163306

Japanese Journal

Opening wedge HTO においてMCL浅層は切離すべきか, 剥離すべきか?

中村立一,池渕公博,松本直幸,西村一志,勝木保夫
JOSKAS 35(3), 668-674, 2010-05-31
NAID 10027616942

脛骨からのMCL引き抜き損傷の診断と治療

武冨修治,内山英司,岩噌弘志,中山修一
JOSKAS 35(1), 176-177, 2010-03-25
NAID 10027615999

Related Pictures

★リンクテーブル★

リンク元	「knee medial collateral ligament」
関連記事	「tibial」「collateral」「collateral ligament」

「knee medial collateral ligament」

Medial collateral ligament
	Diagram of the right knee. (Medial collateral ligament labeled at center right.)
Details
From	medial epicondyle of the femur
To	medial condyle of tibia
Identifiers
Latin	Ligamentum collaterale tibiale
MeSH	A02.513.514.162.600
Dorlands; /Elsevier	l_09/12491979
TA	A03.6.08.012
FMA	44600
	Anatomical terminology [edit on Wikidata]