There are four major ligaments around the knee. Any of these ligaments can be injured in an accident. The most common injury is to the medial collateral ligament which is often strained when the knee is hit from the outside. A strain to the medial collateral ligament is usually treated without surgery as the evidence suggests that these types of injury heal well provided the joint is supported during recovery. Simple sprains - (grade 1) injuries - usually settle over 6-12 weeks following injury. They are associated with local pain and swelling as well as stiffness in the joint. Physiotherapy is the treatment of choice and patients can often be helped with a lightweight brace. A more significant medial collateral ligament injury - for example grade 2 or grade 3 - may also be treated without surgery but occasionally the instability in the joint can make surgery necessary. More significant strains such as grade 2 or grade 3 will require a more formal knee brace for at least 6 weeks following the injury. Beyond that time physiotherapy may need to continue to produce a good recovery which can take up to 6 months.
Lateral Collateral Ligament injuries are much less common this are often associated with an injury to the anterior cruciate ligament as well as causing meniscal tears. Management of an isolated lateral collateral ligament injury would again generally be non-operative; however if this is associated with an injury to the anterior cruciate ligament, combined anterior cruciate ligament surgery and lateral collateral ligament surgery may be necessary.
There are 2 ligaments within the centre of the knee which cross. There is the anterior cruciate ligament which is commonly injured during football, netball and skiing. This ligament provides stability to the knee when twisting. When ruptured, this ligament will not heal itself. For some patients, a combination of physiotherapy and potentially a change in lifestyle may result in a satisfactory outcome; however for others a rupture of this ligament can leave the knee unstable despite physiotherapy and can necessitate surgery to reconstruct the anterior cruciate ligament. Details of this surgery is contained here. Following anterior cruciate ligament reconstruction Simon uses an accelerated rehabilitation protocol which should allow youto get back to sport as quickly as possible.
The other ligament in the centre of the knee is the Posterior Cruciate Ligament. This is relatively rarely damaged and most often requires conservative treatment alone. It may take many months for the effects of a posterior cruciate ligament injury to heal. This generally requires physiotherapy and specific x-rays can be used to monitor your recovery.
When you see Simon to discuss management of a ligament injury to your knee, he will take a careful history, in particular paying attention to the effects of your symptoms on your day-to-day life, and discuss your future plans to return to exercise. Ligament injuries are always investigated with an MRI scan if your knee is unstable. The results of the MRI scan will allow Simon to confirm the severity of your injury and then formulate a management plan to get you back to the activities you enjoy. It can take up to a year following surgery to reach an endpoint in recovery.
