Lateral Collateral Ligament (LCL) Tear Treatment
The lateral collateral ligament — or LCL — is a thin, cord-like band of tissue that runs along the outside of the knee, connecting the femur to the fibula and preventing the joint from opening outward during weight-bearing and lateral movement. LCL tears are less common than ACL or MCL injuries, but when they do occur, they can produce significant instability in the knee joint — particularly a sensation of the knee bowing outward or giving way during side-to-side movements, pivoting, or standing on uneven ground. Because the LCL is located outside the joint capsule and has a more limited blood supply than the MCL on the inner side of the knee, it does not heal as reliably on its own, and complete tears frequently require surgical reconstruction to restore lasting stability. LCL injuries rarely occur in isolation — they are often accompanied by damage to the posterolateral corner structures, the cruciate ligaments, or both — making accurate diagnosis of the full injury pattern critical for determining the right treatment plan.
Dr. Jonathan Glashow is a board-certified orthopedic surgeon and Clinical Associate Professor of Orthopedic Surgery at NYU Grossman School of Medicine, with over 30 years of specialized experience in knee ligament surgery — including the complex multi-ligament injuries that frequently accompany LCL tears. Fellowship-trained in sports medicine and arthroscopic surgery at the Southern California Orthopedic Institute/UCLA, he has the advanced training required for posterolateral corner reconstruction — one of the most technically demanding procedures in knee surgery. As Chief Medical Officer for the New Jersey Devils and Philadelphia 76ers, Dr. Glashow manages acute ligament injuries in professional hockey and basketball players, where direct contact to the inner knee during gameplay is a common mechanism for LCL damage. Named a Castle Connolly Top Doctor every year since 2000, he evaluates and treats LCL tears with same-day imaging at his Upper East Side practice in New York City.
Repairing Severe LCL Tears
Mild or moderate LCL sprains or tears can be treated with conservative methods. Reducing inflammation and supporting the knee joint while the ligament heals is recommended, followed by rehabilitation to strengthen the knee. However, the LCL does not heal as effectively as some of the other knee ligaments. For severe or complete tears, surgery may be required to repair the ligament and restore mobility and stability to the knee joint.
Dr. Glashow is a top sports medicine and orthopedic surgeon who offers lateral collateral ligament tear repairs at our medical facility in Upper East Side NYC. If you have suffered a severe LCL sprain or tear, contact our team to schedule a medical consultation with one of our orthopedic specialists.
Frequently Asked Questions About Lateral Collateral Ligament Tears
What does an LCL tear feel like?
An LCL tear typically produces sharp pain on the outside of the knee at the time of injury, followed by swelling along the outer joint line, tenderness when pressing on the ligament, and a sensation of the knee giving way or bowing outward — particularly when standing on one leg or changing direction. Some patients hear or feel a pop during the initial injury. In more severe cases involving additional posterolateral corner damage, the knee may feel profoundly unstable during walking or weight-bearing.
How is an LCL tear diagnosed?
Dr. Glashow begins with a clinical examination that includes the varus stress test — applying gentle outward force to the knee to assess how much the lateral joint space opens compared to the uninjured side. He also evaluates the posterolateral corner structures with the dial test and posterolateral drawer test to determine whether additional ligaments or structures are involved. X-rays are taken to rule out fractures, and an MRI confirms the location and severity of the tear, identifies any associated injuries to the cruciate ligaments or menisci, and guides surgical planning. Same-day imaging is available at his Upper East Side practice.
What is the difference between an LCL tear and an MCL tear?
The LCL and MCL are located on opposite sides of the knee and are injured by opposite mechanisms. The LCL is on the outer side and tears when a force pushes the knee inward — typically from a blow to the inside of the knee. The MCL is on the inner side and tears when a force pushes the knee outward — typically from a blow to the outside of the knee. The MCL has a better blood supply and more reliable healing capacity than the LCL, which is why isolated MCL tears often heal without surgery while LCL tears — particularly complete ones — more frequently require surgical reconstruction.
Can an LCL tear heal without surgery?
Mild to moderate LCL sprains — where the ligament is stretched or partially torn but the knee remains stable — can often be treated with bracing, rest, and a structured physical therapy program focused on restoring strength and stability to the lateral side of the knee. However, complete LCL tears and injuries involving the posterolateral corner structures typically do not heal reliably without surgery, because the ligament’s location outside the joint capsule limits its access to the healing factors present in synovial fluid. Dr. Glashow evaluates each patient’s injury pattern individually and recommends surgery only when clinical examination and imaging indicate that non-operative treatment will not restore adequate stability.
What does LCL surgery involve?
For acute complete tears, Dr. Glashow may be able to repair the LCL by reattaching it directly to the bone with suture anchors. For chronic tears or injuries where the ligament tissue has retracted or degenerated, a full reconstruction with a tendon graft — typically from the patient’s own hamstring or from a donor source — is performed to recreate the ligament. When the posterolateral corner structures are also damaged, these are reconstructed simultaneously to restore the complete lateral stabilizing complex of the knee. Surgery is performed at Midtown Surgery Center and is typically an outpatient procedure.
How long does recovery take after LCL surgery?
Recovery from LCL repair or reconstruction typically involves six to eight weeks of bracing and protected weight-bearing, followed by a progressive physical therapy program that advances through range-of-motion recovery, strengthening, and sport-specific training over several months. Most patients return to daily activities within two to three months and to full sports or physically demanding work within six to nine months, depending on whether additional structures were repaired and the patient’s individual healing response. Dr. Glashow coordinates rehabilitation closely with physical therapists to ensure the reconstructed ligament heals with optimal stability before clearing each patient for return to activity.
