Knee Ligament Injuries

Get professional Opinion and Treatment about your Knee Ligament Injury. Minimal Invasive to treat your Ligament Injury by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

Ligament injuries in the knee – such as an Anterior Cruciate Ligament (ACL) — are dreaded by professional and amateur athletes alike. They can be painful and debilitating. They can even permanently change your lifestyle.

But there’s good news. While an ACL injury or other ligament damage once ended the career of many an athlete, treatment is much more successful now.

So what’s behind these feared injuries? Ligaments are tough bands of tissue that connect the bones in your body. Two important ligaments in the knee, the ACL and Posterior Cruciate Ligament (PCL),  connect the thigh bone with the bones of the lower leg. But too much stress on these ligaments can cause them to stretch too far or even snap.

ACL injury and other ligament injuries can be caused by:

  • Twisting your knee with the planted.
  • Getting hit on the knee.
  • Extending the knee too far.
  • Jumping and landing on a flexed knee.
  • Stopping suddenly when running.
  • Suddenly shifting weight from one leg to the other.

These injuries are common in soccer players, football players, basketball players, skiers, gymnasts, and other athletes.

There are four ligaments in the knee that are prone to injury.

  • The Anterior Cruciate ligament (ACL) is one of the two major ligaments in the knee. It connects the thigh bone to the shin bone. ACL injuries are a common cause of disability in the knee.
  • The posterior cruciate ligament (PCL) is the second major ligament in the knee connecting the thigh bone to the shin bone.
  • The lateral collateral ligament (LCL) connects the thigh bone to the fibula, the smaller bone of the lower leg.
  • The medial collateral ligament (MCL) also connects the thigh bone to the shin bone.

Anterior Cruciate Ligament (ACL) Injury

One of the most common knee injuries is an anterior cruciate ligament sprain or tear.

Athletes who participate in high demand sports like soccer, football, and basketball are more likely to injure their anterior cruciate ligaments.

If you have injured your anterior cruciate ligament, you may require surgery to regain full function of your knee. This will depend on several factors, such as the severity of your injury and your activity level.

About half of all injuries to the anterior cruciate ligament occur along with damage to other structures in the knee, such as articular cartilage, meniscus, or other ligaments.

Injured ligaments are considered “sprains” and are graded on a severity scale.

Grade 1 Sprains. The ligament is mildly damaged in a Grade 1 Sprain. It has been slightly stretched, but is still able to help keep the knee joint stable.

Grade 2 Sprains. A Grade 2 Sprain stretches the ligament to the point where it becomes loose. This is often referred to as a partial tear of the ligament.

Grade 3 Sprains. This type of sprain is most commonly referred to as a complete tear of the ligament. The ligament has been split into two pieces, and the knee joint is unstable.

Partial tears of the anterior cruciate ligament are rare; most ACL injuries are complete or near complete tears.

Causes of ACL Injuries?

The anterior cruciate ligament can be injured in several ways:

  • Changing direction rapidly
  • Stopping suddenly
  • Slowing down while running
  • Landing from a jump incorrectly
  • Direct contact or collision, such as a football tackle

Several studies have shown that female athletes have a higher incidence of ACL injury than male athletes in certain sports. It has been proposed that this is due to differences in physical conditioning, muscular strength, and neuromuscular control. Other suggested causes include differences in pelvis and lower extremity (leg) alignment, increased looseness in ligaments, and the effects of estrogen on ligament properties.

Symptoms of ACL Injuries?

When you injure your anterior cruciate ligament, you might hear a “popping” noise and you may feel your knee give out from under you. Other typical symptoms include:

  • Pain with swelling. Within 24 hours, your knee will swell. If ignored, the swelling and pain may resolve on its own. However, if you attempt to return to sports, your knee will probably be unstable and you risk causing further damage to the cushioning cartilage (meniscus) of your knee.
  • Loss of full range of motion
  • Tenderness along the joint line
  • Discomfort while walking

Examination of ACL Injuries

  • Physical Examination and Patient History
    During your first visit, our doctor will talk to you about your symptoms and medical history.During the physical examination, our doctor will check all the structures of your injured knee, and compare them to your non-injured knee. Most ligament injuries can be diagnosed with a thorough physical examination of the knee.
  • Imaging Test – Other tests which may help our doctor confirm your diagnosis include:X-rays. Although they will not show any injury to your anterior cruciate ligament, x-rays can show whether the injury is associated with a broken bone.
  • Magnetic resonance imaging (MRI) scan. This study creates better images of soft tissues like the anterior cruciate ligament. However, an MRI is usually not required to make the diagnosis of a torn ACL.

Treatment of ACL Injuries

Treatment for an ACL tear will vary depending upon the patient’s individual needs. For example, the young athlete involved in agility sports will most likely require surgery to safely return to sports. The less active, usually older, individual may be able to return to a quieter lifestyle without surgery.

Nonsurgical Treatment
A torn ACL will not heal without surgery. But nonsurgical treatment may be effective for patients who are elderly or have a very low activity level. If the overall stability of the knee is intact, your doctor may recommend simple, nonsurgical options.

  • Bracing. Our doctor may recommend a brace to protect your knee from instability. To further protect your knee, you may be given crutches to keep you from putting weight on your leg.
  • Physical therapy. As the swelling goes down, a careful rehabilitation program is started. Specific exercises will restore function to your knee and strengthen the leg muscles that support it.

Surgical Treatment
Rebuilding the ligament: Most ACL tears cannot be sutured (stitched) back together. To surgically repair the ACL and restore knee stability, the ligament must be reconstructed. Our doctor will replace your torn ligament with a tissue graft. This graft acts as a scaffolding for a new ligament to grow on.

Grafts can be obtained from several sources. Often they are taken from the patellar tendon, which runs between the kneecap and the shinbone. Hamstring tendons at the back of the thigh are a common source of grafts. Sometimes a quadriceps tendon, which runs from the kneecap into the thigh, is used. Finally, cadaver graft (allograft) can be used.

There are advantages and disadvantages to all graft sources. You should discuss graft choices with your own orthopaedic surgeon to help determine which is best for you.

Because the regrowth takes time, it may be six months or more before an athlete can return to sports after surgery.

Procedure: Surgery to rebuild an anterior cruciate ligament is done with an arthroscope using small incisions. Arthroscopic surgery is less invasive. The benefits of less invasive techniques include less pain from surgery, less time spent in the hospital, and quicker recovery times.

Unless ACL reconstruction is treatment for a combined ligament injury, it is usually not done right away. This delay gives the inflammation a chance to resolve, and allows a return of motion before surgery. Performing an ACL reconstruction too early greatly increases the risk of arthrofibrosis, or scar forming in the joint, which would risk a loss of knee motion.

Get professional Opinion and Treatment about your Knee Ligament Injury. Minimal Invasive to treat your Ligament Injury by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

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