New York State Medical Treatment Guidelines for Collateral Ligament Injury in workers compensation patients

The New York State Workers Compensation Board has established directives for addressing Collateral Ligament Injury, aiming to aid physicians, , and healthcare practitioners in determining the suitable treatment for this condition.

Healthcare professionals specializing in Collateral Ligament Injury can rely on the Workers Compensation Board’s guidelines to make well-informed decisions regarding the optimal level of care for their patients.

It is essential to underscore that these guidelines are not intended to replace clinical judgment or professional expertise. The final decision regarding care should be a cooperative endeavor involving the patient and their healthcare provider.


Injury involving a sprain/strain or rupture of the medial or lateral collateral ligament.An injury to the medial collateral ligament may also be linked with a concurrent injury to the medial meniscus.


Mechanism of Injury

Valgus or varus trauma involves a force applied to the knee.


Specific Physical Findings

Medial-lateral instability should be assessed with the knee in slight flexion. Tenderness over the medial or lateral collateral ligament may increase with valgus or varus force applied to the knee.


Diagnostic Testing Procedures

Magnetic resonance imaging (MRI) is recommended in select patients with suspected Grade II or Grade III tears.


Non-Operative Treatment

Isolated Grade I collateral ligament tears and many Grade II tears have demonstrated the ability to heal with excellent outcomes without the need for surgical intervention. When accompanying injuries to the cruciate ligaments or meniscus are ruled out, non-operative treatment can be pursued for the patient.

Is recommended in select patients as clinically indicated.

Treatment approaches for this condition may include rest or restricted activity, off-loading with crutches or a cane, application of ice, elevation, bracing, casting, orthotics, rehabilitation, and active and/or passive therapy. Nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen (APAP), and therapeutic injections can also be considered.


Surgical Indications

Is recommended in select patients as clinically indicated.

Indications for a complete Grade III collateral ligament tear include a recommendation for referral to an orthopedic surgeon.



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