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Knee Ligament injury
Ligaments are strong bands of tissue that connect bones to one another and help provide stability and strength to a joint. Knee stability depends on a complex group of ligaments that span the joint. The main ligaments are:
• Anterior Cruciate Ligament (ACL): located in the centre of the knee, controlling rotation and
forward movement of the tibia (shin bone).
• Posterior Cruciate Ligament (PCL): located in the centre of the knee, controlling backward
movement of the tibia.
• Medial Collateral Ligament (MCL): located on the inner side of the knee.
• Lateral Collateral Ligament (LCL): located on the outer side of the knee.
These ligaments can sustain a range of injuries, from a mild sprain to a complete tear or rupture. One of the most common and significant ligament injuries of the knee is an ACL rupture, which is explained below.
Anterior Cruciate Ligament (ACL) Injury
The ACL is usually injured when it is overstretched during a sudden impact combined with a twisting movement. This type of injury is commonly seen in sports such as rugby, football, skiing and running activities. Patients may feel a sudden “pop” or “snap” at the time of injury, followed quickly by swelling around the knee.
In the early stage after the injury, there is often pain, difficulty walking and restriction of knee movement. In the longer term, patients may continue to experience instability, or a sensation that the knee is “giving way”.
Diagnosis
The diagnosis of an ACL rupture is usually made by a specialist following a clinical assessment and specific examination tests during the outpatient consultation. Further investigations, such as X-rays and an MRI scan, are usually required to confirm the diagnosis and to identify any associated injuries within the knee, such as a meniscal tear.
Treatment
Treatment depends on the severity of the injury, the level of instability and the patient’s activity demands. In many complete ACL ruptures, particularly in active individuals, ACL reconstruction surgery may be recommended as a gold-standard treatment option.
The aim of the operation is to replace the torn ligament with a graft. This graft is commonly taken from the patient’s own tissues, such as and commonly hamstring tendons, through small incisions. The graft is then passed through prepared tunnels in the tibia and femur, at the site of the original ACL, and secured in place using special fixation devices. This reconstructs the function of the torn ligament and helps restore knee stability.
In some cases, Mr. Ayoub may also consider adding an additional procedure during the operation to reinforce another ligament on the front and outer side of the knee, known as the Anterolateral Ligament (ALL). This may be recommended when needed in order to further improve the stability of the knee.
Mr. Ayoub performs ACL reconstruction using arthroscopic (keyhole) techniques and specialised instruments designed for this procedure. The operation is usually carried out as a day-case procedure, although occasionally an overnight stay may be required.
Following surgery, the patient will need a structured and specific course of physiotherapy and rehabilitation to improve movement, strength and stability of the knee. The aim is to help the patient return to work, sport and normal daily activities as safely and as quickly as possible.
Further detailed information and the appropriate treatment option will be provided to you by Mr. Ayoub during the consultation. Back...
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