Knee ligament injuries

Knee ligament injuries occur often during contact sports such as football, hockey, basketball, rugby, etc. Road traffic accidents can also cause these injuries.

Includeligaments of the knee which can suffer injury

Medial collateral ligament (MCL) lateral collateral ligament (LCL) anterior cruciate ligament (ACL) posterior cruciate ligament (PCL)

Before reading further, it would be good to review the section on the Anatomy(skip_if_you_have_already_done_so) of the knee.

First, we look at collateral ligament injuries.

Mechanism of injury. MCL in wounded by a force applied to the external appearance of the knee joint, which tends to open corner of the knee joint on the inside, with feet firmly planted on the ground. Lateral collateral ligament (LCL) is wounded by the same way, but with the force acting on the internal aspect of the knee joint.

If the same force continues to act then crossed ligaments may also obtain injuries.

Ligament injuries collateral can be classified into three categories depending on the seriousness of the injury. Tests carried out by the mechanism of the injury of reproduction by the examiner and the opening of the joint assessment.

Grade 1. -Less opening of 5mmGrade 2. -Opening between 5-10mmGrade 3. -Opening beyond 10 mm

The diagnosis is made by history and clinical examination.

Patient will give a history of trauma, followed by pain on injured ligament.Swelling may be present (rank 2).Patient may have had a sensation of tearing at the time of the injury (3rd).Patient may have a feeling of weakness or instability in the knee joint (articulation appears to loop during walking).Tenderness is present on the torn ligament.

X-ray of the knee are normal, except the ligament was separated from its attachment to the bone carrying with it a bone chip.

MRI scan can show the real site of the tear. It is useful to assess the degree of injury and the integrity of other ligaments.

Treatment is the rank of the injury and the presence of injuries associated with the ACL.

Grade 1 and 2 injuries rarely involve the ACL. They are treated as follows... As the instability is not a problem in these injuries therefore treatment is directed at the reduction of pain and inflammation and beginning of activity back to normal.Ice and anti-inflammatory medication is used.Activity is limited till the patient is comfortable.A knee cap or brace may be used to protect the knee of the aggravation of the injury.After the pain completely disappeared exercises are initiated to regain strength.

Grade 3 lesions , the integrity of the crossed ligament is established with an MRI or an Arthroscopy.

If crossed ligaments are intact then treatment is the same as grade 1 and 2 except that brace use may be required for a longer time. If crossed ligaments are torn apart by surgery is made.

It is an x-ray of a young man injured his medial collateral ligament when he was trying to sit on his bike wear tight pants. He lost his balance and fell. Its x-ray shows avulsion of the attachment of the medial collateral ligament on the femur (small red arrow). As all the other ligaments were intact from where he was treated effectively with a knee brace, analgesics and anti-inflammatory drugs.

With ACL injury mechanism is the same as MCL. ACL ruptures when the force continues to act after the breakdown of the LFA. Hyperextension of the knee joint can also rupture of the ACL.PCL is broken by a force pushing the leg behind with the foot firmly planted on the ground.

Symptoms include

serious pain and joint swellingknee feels weaklimping is present

The diagnosis is by history and examination. Various tests are used by the examiner to determine a rupture of the ligament. In these tests, the examiner manipulates the affected Member in various positions of flexural extension and tries to feel for abnormal mobility of the tibia relative to the other side.

These tests include

Lachman testAnterior drawer testPosterior drawer testReverse pivot shift test

Surveys conducted to assess the integrity of ACL and PCL include Arthroscopy and MRI. Visualization of PCL is hard on MRI and Arthroscopy.

Classification of cruciate ligament injury is the degree of translation of the tibia while performing tests of drawer.

Grade 1 - translation less than 5mmGrade 2 - translation between 5-10mmGrade 3 - translation between 10-15mmGrade 4 - translation over 15 mm

Treatment of ACL injury

Treatment of PCL injury

PCL is separated with a large bone fragment, then the piece of bone is fixed with screws. It automatically corrects the ligament.Tears PCL of grade 1 and 2 are treated with anti-inflammatory drugs, use of exercises brace and knee rehabilitation.Tears of grade 3 are processed by the ligament reconstruction.

When surgery should be undertaken to injury crossed?

Among active athletes surgery should be done with in a few days of injury.

How are the crossed ligament repaired?

Crusader ligaments are not repaired they are rebuilt. This means that the ligament is not-to-end joined by sutures but the whole ligament is formed from other tissues of the body (usually patellar tendon) and fixed to the place of the original ligament.

What are the complications of this surgery?

Main complications of this surgery are residual laxity (crack) in the reconstructed ligament and the loss of certain movements.

How long does take to return to sports activities after the cruciate ligament injury?

It can take between 2 to 6 months depending on the severity of the injury.

A non-athletic person with a cross-tear need surgery?

Rarely, it may require surgical intervention continually if the knee is symptomatic.

I hope that the information provided was useful. If you have any query on the ligament injuries you can ask me to contact me page.

This page was last updated on January 21, 2009.

Among the other causes of knee pain...

Osteoarthritis of the knee

Knee bursitis

Meniscal

Fracture of the knee

Fracture of the patella

Fracture of tibial Plateau

Osgood Schlatter disease

Anatomy of the knee

Knee replacement surgery

Return to the pain in his knee Ligament injuries

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