Knee Ligament Injuries

The knee is a complex joint which consists of bone, cartilage, ligaments and tendons that make joint movements easy and at the same time more susceptible to various kinds of injuries. Knee problems may arise if any of these structures get injured by overuse or suddenly during sports activities. Pain, swelling, and stiffness are the common symptoms of any damage or injury to the knee. Various types of knee injuries include:

  • Fracture of the femur (thigh bone) or tibia and fibula (leg bones)
  • Torn ligament - anterior cruciate ligament (ACL), posterior cruciate ligament (PCL). Lateral collateral ligament (LCL), medial collateral ligament (MCL)
  • Dislocation of knee cap (patella)
  • Torn quadriceps or hamstring muscles or tendons.
  • Patellar tendon tear

ACL tear

An ACL injury is a sports related injury that typically occurs with a twisting motion or hyperextension. An ACL tear usually occurs with an abrupt directional change with the foot fixed on the ground or when the deceleration force crosses the knee. Changing direction rapidly, stopping suddenly, slowing down while running, landing from a jump incorrectly, and direct contact or collision, such as a football tackle can also cause injury to the ACL.  A pop can be felt or heard, and the knee typically becomes quite swollen after the injury.

MCL tear

The medial collateral ligament (MCL) is the ligament that is located on the inner part of the knee joint. It runs from the femur (thigh bone) to the top of the tibia (shin bone) and helps in stabilizing the knee. Medial collateral ligament (MCL) injury can result in a stretch, partial tear, or complete tear of the ligament. Injuries to the MCL commonly occur because of a impact on the outer part of the knee, or a bending force towards the inside of the knee. They can be associated with injuries to other ligaments.

LCL tear

The laterall collateral ligament (LCL) is the ligament that is located on the outer part of the knee joint. It runs from the femur (thigh bone) to the top of the fubula and helps in stabilizing the knee. Lateral collateral ligament (LCL) injury can result in a stretch, partial tear, or complete tear of the ligament. Injuries to the LCL commonly occur because of a impact on the inner part of the knee, or a bending force towards the outside of the knee.  They can be associated with injuries to other ligaments.

PCL tear

PCL injuries are somewhat less common.  Cartilage injuries, bone bruises, and ligament injuries often occur in combination with PCL injuries. Injuries to the PCL can be graded as I, II or III depending on the severity of injury.  The PCL is usually injured by a direct impact, such as in an automobile accident when the bent knee forcefully strikes the dashboard. In sports, it can occur when an athlete falls to the ground with a bent knee. Twisting injury or overextending the knee can cause the PCL to tear.  Isolated PCL tears can sometimes be treated non-surgically.  The PCL can also be torn in conjunction with other ligament injuries in the knee (multiligamentous knee injury).

Treatment

Immediately following a knee injury before being evaluated by a doctor, you can initiate the R.I.C.E. method of treatment:

  • Rest: Rest the knee as more damage could result from pressure on the injury
  • Ice: Ice packs can be applied to the injured area to reduce swelling and pain.  Never place ice directly over the skin. Ice should be wrapped in a towel and applied to the affected area for 15-20 minutes four times in a day for several days
  • Compression: Wrapping the knee with an elastic bandage or compression stocking can help minimize the swelling and support your knee
  • Elevation: Elevating the knee above the heart level will also help reduce swelling and pain.  

It is important to seek your doctor’s advice if you hear a popping noise or feel as if your knee has given way at the time of injury and if you are unable to move your knee because of severe pain. 

Treatment for ligamentous injuries may range from bracing of the knee to allow healing of ligaments (more common for collateral ligament injuries), to surgical procedures to reconstruct the ligamentous.  Dr. Dumont will review your clinical exam, imaging, and discuss treatment options with you.

  • American Orthopaedic Society for Sports Medicine
  • The Arthroscopy Association of North America
  •  American Academy of Orthopaedic Surgeons
  • International Society for Hip Arthroscopy