LCL Reconstruction
Also known as: lateral collateral ligament reconstruction
Lateral collateral ligament (LCL) reconstruction is a surgical procedure used to repair or rebuild the LCL, a key ligament located on the outer side of your knee.
What is the Lateral Collateral Ligament?
The lateral collateral ligament (LCL) is a vital component of the knee joint, providing stability and limiting sideways movement. It is one of the four primary ligaments of the knee, along with the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and medial collateral ligament (MCL). The LCL is located on the outer side of the knee and connects the thighbone (femur) to the fibula (side bone of the lower leg). Injuries to the LCL can occur due to trauma, sports injuries, or direct blows to the knee, resulting in pain, swelling, and instability of the knee.
What is LCL reconstruction?
Lateral collateral ligament (LCL) reconstruction is a surgical procedure used to repair or rebuild the LCL, a key ligament located on the outer side of your knee. This ligament helps stabilise the knee, especially during side-to-side movements.
LCL reconstruction typically involves a small incision through which the surgeon reconstructs the damaged ligament. This graft may come from your own body, such as the hamstring or thigh muscle (autograft), be a donor (allograft), or a be a synthetic graft.
It’s important to note that surgery is generally considered only after non-surgical treatments have been explored. However, in cases of significant trauma or sports injuries, LCL reconstruction may be necessary for full recovery.
Since LCL reconstruction is an open procedure (not minimally invasive), recovery can take longer compared to less invasive surgeries. Your surgeon will discuss all options with you to determine the best course of action based on your specific condition and needs.
Benefits of LCL reconstruction
LCL reconstruction surgery can provide several benefits, including restored stability and function of the knee joint. The procedure can help alleviate pain and discomfort associated with LCL injuries and prevent further damage to the knee. LCL reconstruction can also enable individuals to return to normal activities, including sports and vigorous exercise. Advanced surgical techniques and materials, such as tendon grafts and suture anchors, can provide a durable and long-lasting solution for LCL injuries. Additionally, LCL reconstruction can help prevent long-term complications, such as arthritis and chronic knee instability.
Causes of LCL tears
LCL tears can be caused by various factors, including sports injuries, falls, and direct blows to the knee. These injuries can occur when the knee is subjected to a sudden twisting motion or a direct hit, causing the LCL to stretch or tear. LCL tears can also occur in conjunction with other knee injuries, such as ACL or PCL tears. The severity of the tear can range from a partial tear to a complete rupture, and treatment options vary depending on the severity of the injury.
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Ways to payBefore treatment
During your initial consultation, your orthopaedic consultant will perform a physical examination and discuss the details of your LCL injury and the surgical interventions that may be advised. Your surgeon will also most likely order some imaging scans, such as X-rays or an MRI.
To ensure the success of the collateral ligament LCL reconstruction surgery, you may need to follow specific preoperative guidelines. Ignoring these instructions could lead to complications, further injury to the LCL, or emergency medical intervention.
Some precautions include:
- Avoiding anti-inflammatory medications for seven days before surgery to reduce the risk of excessive bleeding. This includes any sports medicine used to manage swelling. Be sure to inform your healthcare provider and surgical team if you are taking such medications
- Informing your healthcare providers if you have been ill recently, including common colds or flu, especially if you have received treatment or medications
- Preparing your home to minimise the risk of injury to your knee joint by removing clutter and ensuring a safe environment
- Arranging for someone to take you home after the procedure, as you won’t be able to drive
During treatment
When the procedure begins, you’ll be placed under general anaesthesia, so you’re fully asleep and comfortable.
Using a small incision on the outside of your knee, your surgeon will locate the torn LCL. If the ligament is suitable for repair, it will be reinforced using a technique called suture augmentation – this adds strength to your natural tissue without needing a full ligament replacement. In some cases, if the tear is more extensive, a tendon graft may be used to reconstruct the ligament. These grafts are passed through tiny tunnels made in the bone and secured with special anchors or screws.
Throughout the procedure, your surgeon will carefully test the stability of your knee to make sure the repair is strong. Once everything is in place, the incision is closed, and you’ll be moved to recovery, where we’ll monitor you as you begin to wake up.
After treatment
To protect your healing knee, you’ll need to avoid putting weight on it for a while. Most patients use crutches during this period. Some discomfort, such as pain, swelling, or bruising, is expected, but we’ll prescribe medication to help manage this and keep you as comfortable as possible.
Recovery times can vary. If you’ve had unsuccessful non-surgical treatments in the past, or if there were additional injuries, like pressure on the iliotibial band or damage to the peroneal nerve, your healing process may take longer.
Depending on how your knee is responding, gentle rehabilitation may begin within the first two weeks after surgery, focusing on basic movement and muscle activation. More structured physical therapy will usually start around the four- to six-week mark. Our physiotherapy team will work closely with you to rebuild strength, improve flexibility, and restore balance.
Your progress will be monitored carefully. Your therapist may use clinical assessments or imaging, like varus stress tests or radiographs, to evaluate healing and ensure the repaired ligament is regaining stability.
Most people recover from an LCL injury within four to six months, although return to high-level sports may take longer. It can be tempting to speed things up, but pushing too hard too soon may risk reinjury to the ligament or surrounding structures. Taking the time to recover properly is the best way to avoid setbacks—and to get you safely back to the activities you love.
We’ll be with you at every step to support your healing and help you return to full strength with confidence.
Reconstruction surgery risks and complications
LCL reconstruction surgery, like any other surgical procedure, carries risks and complications. These can include infection, blood clots, nerve damage, and tendon graft failure. Additionally, there is a risk of instability or a limited range of motion after surgery. The use of suture anchors, metal staples, or large sutures can also lead to complications. Furthermore, the drilling of the thighbone and fibula bones can cause damage to the surrounding tissues. It is essential to discuss these risks and complications with an orthopaedic surgeon before undergoing LCL reconstruction surgery.
Appointment and Treatment Plan
Initial Consultation
You’ll meet with your orthopaedic surgeon to discuss your LCL injury. A physical exam and imaging tests (like X-rays or MRI) will help confirm the diagnosis and determine if surgery is needed.
Pre-Surgery Preparations
Before surgery, you’ll be asked to stop certain medications, report any recent illness, and prepare your home to avoid tripping or straining your knee. These steps help minimise surgical risks and support a smooth recovery.
Day of Surgery
You’ll be placed under general anaesthesia. Depending on the injury, the surgeon may repair the ligament with stitches (suture augmentation) or use a tendon graft to reconstruct it. The procedure is done through a small incision on the outer knee.
Immediately After Surgery
After surgery, you’ll be monitored as you wake up. Your knee will be protected, and you’ll likely need to use crutches. Some swelling and pain are normal and will be managed with prescribed medication.
Early Recovery at Home
You’ll avoid putting weight on your leg for a while. Gentle rehab may begin within the first two weeks to activate muscles and maintain movement. Follow your surgeon’s instructions closely.
Physical Therapy
Structured physical therapy usually starts around 4 to 6 weeks post-op, focusing on strength, flexibility, and balance. Progress is monitored with clinical tests or imaging.
Full Recovery
Most people recover in 4 to 6 months, though returning to sports can take longer. Taking recovery slowly helps prevent reinjury and leads to the best long-term results.
Experts
We are proud to provide patients with access to a wide range of clinicians, chosen specifically for their knowledge and reputation in their area of expertise. Our experts align with our values: putting you at the centre of your care and educating you on your options at each step of the journey. We encourage you to learn more about our clinicians and how they can help you below. As always, please contact our patient services team if you require any additional information.
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Many of our treatments have a pay monthly option that allows you to spread the cost of your treatment over 12 months with no credit checks required.
A minimum spend of £300 does apply. We’ll take your first payment upfront and then arrange a direct debit for your monthly payments thereafter. It’s that simple.
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FAQs
Recovery time for LCL reconstruction surgery typically ranges from four to six months, depending on the severity of the injury and the patient’s adherence to rehabilitation programs. Initially, patients must avoid putting weight on the affected leg and often use crutches. Physical therapy usually begins around four to six weeks after surgery to restore strength, flexibility, and stability to the knee joint. Full recovery can take up to six months or longer, especially if there were other injuries involved or if non-surgical interventions failed before surgery.
Yes, ligament reconstruction is considered a major surgical procedure. It involves making an open incision on the lateral side of the knee to access the damaged LCL. The surgeon employs specialised instruments to remove the torn ligament and replace it with a tendon graft, which may be harvested from the patient (called autograft),obtained from a tissue bank (called allograft), or be a synthetic ligament. The graft is then fixed to the femur and fibula head using screws or suture anchors. The surgery typically lasts one to two hours under general anaesthesia. Due to the complexity and invasiveness of the procedure, patients require careful post-operative care, including prescribed medications and rehabilitation programs to ensure proper healing and to provide stability to the knee joint.
An LCL tear can range from mild to severe, depending on the extent of ligament damage. Mild sprains may heal with non-surgical interventions such as bracing with a hinged brace and physical therapy. However, a complete or severe tear often results in knee instability, pain, and difficulty putting weight on the affected leg. Because the LCL is crucial for stabilising the lateral aspect of the knee, a torn LCL can compromise knee function and increase the risk of further injuries, especially to the posterolateral corner and other collateral ligaments. In cases of isolated injury or when accompanied by other knee injuries, surgical reconstruction may be necessary to restore full function.
Pain from an LCL sprain varies based on the injury’s severity. Mild sprains typically cause localised pain and tenderness on the outer side of the knee, which may be managed with rest, ice, and non-prescription pain relief. Moderate to severe sprains or tears can cause significant pain, swelling, and instability, making activities such as walking or putting weight on the leg difficult. Post-surgical pain is managed with prescribed medications, and patients may experience some discomfort during rehabilitation exercises. Using a knee brace and following prescribed physical therapy can help reduce pain and support healing.
In many cases, especially with mild to moderate LCL injuries or isolated injuries, the ligament can heal without surgery through non-surgical interventions. These include rest, the use of a knee brace or hinged brace to provide stability, physical therapy to strengthen surrounding muscles, and avoiding activities that put stress on the damaged ligament. Employing imaging techniques such as MRI scans helps doctors assess the extent of the injury and decide if surgery is necessary. However, if non-surgical treatments fail or if the injury is severe with a torn ligament that compromises knee stability, LCL reconstruction surgery may be required to restore proper function.
Medically reviewed by Mr Ravi Popat - Consultant Orthopaedic Surgeon on 16/06/2025