Medial Collateral Knee Ligament Injury Medication
- Author: Thomas M DeBerardino, MD; Chief Editor: Craig C Young, MD more...
Medication Summary
The goals of pharmacotherapy are to reduce morbidity and to prevent complications.
Nonsteroidal anti-inflammatory drugs
Class Summary
Have analgesic, anti-inflammatory, and antipyretic activities. Their mechanism of action is not known, but they may inhibit cyclooxygenase activity and prostaglandin synthesis. Other mechanisms may exist as well, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell membrane functions.
Ibuprofen (Ibuprin, Motrin)
DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.
Naproxen (Anaprox, Naprosyn, Naprelan, Aleve)
For relief of mild to moderate pain; inhibits inflammatory reactions and pain by decreasing activity of cyclooxygenase, which results in a decrease of prostaglandin synthesis.
Ketoprofen (Orudis, Oruvail, Actron)
For relief of mild to moderate pain and inflammation.
Small dosages are initially indicated in small and elderly patients and in those with renal or liver disease.
Doses >75 mg do not increase therapeutic effects. Administer high doses with caution and closely observe patient for response.
Sulindac (Clinoril)
Decreases activity of cyclooxygenase and in turn inhibits prostaglandin synthesis. Results in a decreased formation of inflammatory mediators.
Analgesics
Class Summary
Pain control is essential to quality patient care. Analgesics ensure patient comfort, promote pulmonary toilet, and have sedating properties, which are beneficial for patients who have sustained trauma or have sustained injuries.
Propoxyphene/acetaminophen (Darvocet N-100)
Drug combination indicated for mild to moderate pain.
Acetaminophen (Tylenol, Feverall, Aspirin-Free Anacin, Tempra)
DOC for pain in patients with documented hypersensitivity to aspirin or NSAIDs, with upper GI disease, or who are taking PO anticoagulants.
Codeine/acetaminophen (Tylenol and codeine)
Indicated for the treatment of mild to moderate pain.
Hydrocodone and acetaminophen (Vicodin, Lortab, Norcet, Margesic)
Drug combination indicated for moderate to severe pain.
Hydrocodone and ibuprofen (Vicoprofen)
Drug combination indicated for short-term (< 10 d) relief of moderate to severe acute pain.
Oxycodone and acetaminophen (Percocet, Roxilox, Roxicet, Tylox)
Drug combination indicated for the relief of moderate to severe pain.
Chahal J, Al-Taki M, Pearce D, et al. Injury patterns to the posteromedial corner of the knee in high-grade multiligament knee injuries: a MRI study. Knee Surg Sports Traumatol Arthrosc. Dec 15 2009;[Medline].
Griffith CJ, LaPrade RF, Johansen S, et al. Medial knee injury: part 1, static function of the individual components of the main medial knee structures. Am J Sports Med. Sep 2009;37(9):1762-70. [Medline].
Wijdicks CA, Griffith CJ, LaPrade RF, et al. Medial knee injury: part 2, load sharing between the posterior oblique ligament and superficial medial collateral ligament. Am J Sports Med. Sep 2009;37(9):1771-6. [Medline].
Laprade RF, Bernhardson AS, Griffith CJ, et al. Correlation of valgus stress radiographs with medial knee ligament injuries: an in vitro biomechanical study. Am J Sports Med. Dec 4 2009;[Medline].
Laprade RF, Bernhardson AS, Griffith CJ, Macalena JA, Wijdicks CA. Correlation of valgus stress radiographs with medial knee ligament injuries: an in vitro biomechanical study. Am J Sports Med. Feb 2010;38(2):330-8. [Medline].
Lind M, Jakobsen BW, Lund B, et al. Anatomical reconstruction of the medial collateral ligament and posteromedial corner of the knee in patients with chronic medial collateral ligament instability. Am J Sports Med. Jun 2009;37(6):1116-22. [Medline].
Albright JP, Powell JW, Smith W, et al. Medial collateral ligament knee sprains in college football. Effectiveness of preventive braces. Am J Sports Med. Jan-Feb 1994;22(1):12-8. [Medline].
Fanelli GC, Edson CJ, Orcutt DR, et al. Treatment of combined anterior cruciate-posterior cruciate ligament-medial-lateral side knee injuries. J Knee Surg. Jul 2005;18(3):240-8. [Medline].
Halinen J, Lindahl J, Hirvensalo E, Santavirta S. Operative and Nonoperative Treatments of Medial Collateral Ligament Rupture With Early Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Study. Am J Sports Med. Feb 1 2006.
Lundberg M, Messner K. Long-term prognosis of isolated partial medial collateral ligament ruptures. A ten-year clinical and radiographic evaluation of a prospectively observed group of patients. Am J Sports Med. Mar-Apr 1996;24(2):160-3. [Medline].
Lundberg M, Messner K. Ten-year prognosis of isolated and combined medial collateral ligament ruptures. A matched comparison in 40 patients using clinical and radiographic evaluations. Am J Sports Med. Jan-Feb 1997;25(1):2-6. [Medline].
Reider B. Medial collateral ligament injuries in athletes. Sports Med. Feb 1996;21(2):147-56. [Medline].
Reider B, Sathy MR, Talkington J, et al. Treatment of isolated medial collateral ligament injuries in athletes with early functional rehabilitation. A five-year follow-up study. Am J Sports Med. Jul-Aug 1994;22(4):470-7. [Medline].
Warren LF, Marshall JL. The supporting structures and layers on the medial side of the knee: an anatomical analysis. J Bone Joint Surg Am. Jan 1979;61(1):56-62. [Medline].

