Knee Ligament Injuries

Knee ligament injuries develop when the knee is stressed in an unusual way. There are many ways in which this can happen: a tackle or collision during sports or an accident, landing incorrectly from a jump, stopping suddenly, or pivoting with your foot firmly planted on the ground. Most actions which extend the leg forward too far or twist your knee and lower leg have potential to cause knee ligament injuries.

Different actions are more likely to damage different knee ligaments: both collateral ligaments are most often injured through a blow to the outer side of the knee, while the ACL is more likely to be torn through a twisting motion.

Avoidable causes of knee ligament injuries in sports include:

·      Improper technique – learning to jump, land, and move properly for your sport is critical to preventing ligament injuries

·      Poor equipment – playing with misfitted footwear, on unmaintained surfaces, and using equipment that is not properly adjusted can significantly increase your risk of injury.

Your doctor will begin diagnosing a ligamentous knee injury with a physical examination of your knee. They will compare your injured knee’s side and shape to your uninjured one, look for abnormalities, and may ask you to attempt specific movements. They will also ask you questions about how the injury occurred, whether you have had knee injuries previously, and you overall health.

If they suspect a knee ligament injury, your doctor will usually order one or more imaging tests to confirm it and help determine your treatment options. The imaging tests used may include:

·      MRI scan – using radio waves and a strong magnetic field, an MRI generates an image of your knee’s soft structures which can show damaged or torn ligaments. Though not always necessary to diagnose a knee ligament injury, it can help doctors assess the injury’s extent and plan for surgery if needed.

·      X-rays – though they will not show damage to the knee ligaments explicitly, x-rays can show additional damage to the knee’s bones if present.

·      Ultrasound – this test uses sound waves to visualise your knee’s internal structures and check them for physical abnormalities. It may let your doctor see whether one or more knee ligaments are damaged and how severely they are injured.

Immediately after a knee injury occurs, applying the RICER first aid protocol (rest, ice, compression, elevation, referral) is the best course of treatment. Seek a referral to Orthopaedics SA as soon as possible afterwards for a full assessment.

Your treatment options for a ligamentous knee injury depend on which ligament(s) are injured, the extent of damage, and your lifestyle needs. Many knee ligament injuries can be treated without surgery, especially if they are not severe. Your nonsurgical treatment options may include:

·      Resting the knee by avoiding high-impact activities or using crutches for a few weeks

·      Using a supportive brace to immobilise your knee as it heals

·      Taking over-the-counter NSAID medications (like Nurofen or Advil) to reduce pain and swelling

·      Speaking to a physiotherapist about exercises which will improve your knee strength

·      Corticosteroid or platelet-rich plasma (PRP) injections to promote healing

However, it should be noted that tendons which have fully torn do not heal without surgery. If you have full-thickness tear, injuries to more than one ligament, or other damage to your knee, surgical treatment may be preferable. Depending on the exact nature of your injury, your surgical options may include:

·      Knee arthroscopy – this procedure involves passing a tiny camera with a light attached to it (an arthroscope) into your knee joint through a small incision. Once it’s in, your orthopaedic surgeon can use it to inspect the knee’s damage from the inside and determine an exact course of treatment. In many cases, they can use the arthroscope to perform a full reconstructive procedure with the help of tiny tools passed through a few more small cuts in your knee.

·      Knee ligament reconstruction – as ligaments such as the ACL often cannot be stitched back together, your doctor may recommend a reconstructive surgery to help restore your knee’s stability. This involves taking a tendon graft from elsewhere in your body and attaching it to the knee bones, replacing the damaged one.

The disadvantage of knee surgery is that it takes time to heal. Recovering from a ligament reconstruction surgery often takes six or more months, though the restored stability it provides can be game-changing for athletes and people with active lifestyles. To find out which approach is best for you, ask for a referral to Orthopaedics SA.