Knee Ligament Tears2016-10-12T12:39:56-04:00

ACL and Other Knee Ligament Tears


The knee has several ligaments, most commonly referred to by the three-letter abbreviations. The ligaments within the knee include:

  • LCL (lateral collateral ligament): connects the thigh bone to the fibula, the smaller bone of the lower leg on the lateral or outer side of the knee.
  • ACL (anterior cruciate ligament): one of the two major ligaments in the knee. It connects the thigh bone to the shin bone in the knee.
  • PCL (posterior cruciate ligament): the second major ligament in the knee connecting the thigh bone to the shin bone in the knee.
  • MCL (medial collateral ligament): also connects the thigh bone to the shin bone on the medial, or anterior, side of the knee.

Ligaments are tough bands of tissue that connect the bones in your body. The ligaments around the knee are strong. However, they can become injured. The ligaments may be stretched (sprained), or sometimes torn (ruptured). A ligament rupture can be partial (some of the fibers that make up the ligament are torn) or complete (the ligament is torn through completely). The majority of knee ligament injuries are sprains and not tears and they tend to resolve quickly.

Causes of a Knee Ligament Tear

The knee is comprised of ligaments and tendons that work together connecting the femur bone in the thigh to the smaller bone below the knee called the tibia. During intense sporting activities such as soccer, football, gymnastics or skiing, the knee is expected to make quick stops and starts often under the heavy load of a moving body. However, too much stress on these ligaments may cause them to stretch too far or even snap. The following list contains some examples of how ligaments in the knee may tear:

  • Twisting knee with the foot planted
  • Getting hit on the knee or falling 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
  • Moving outside the normal range of motion

Symptoms of a Knee Ligament Tear

Symptoms of a knee ligament injury are dependent on the severity of the injury. A complete tear in one of the ligaments will severely reduce the movement of the knee and make bearing weight impossible. A strain of a ligament may still be problematic, but has a better overall outcome. Urgent medical attention to a strain or tear of the ligament in the knee is critical for the best outcome for the health of the knee. Some symptoms of a ligament tear in the knee include:

  • Pain, often sudden and severe
  • A loud pop or snap during the injury
  • Swelling
  • A feeling of looseness in the joint
  • Inability to put weight on the point without pain

Treatment of Knee Ligament Tear

A mild to moderate injury to a ligament in the knee may heal on its own in time. Just as in an ankle sprain, the RICE procedure will also work for the knee. Adding the following measures to the care of your knee to help it heal more quickly:

  • Rest the knee. Avoid putting excess weight on your knee if it’s painful to do so. You may need to use crutches for a time.
  • Ice your knee to reduce pain and swelling. Do it for 20-30 minutes every 3-4 hours for 2-3 days, or until the pain and swelling is gone.
  • Compress your knee. Use an elastic bandage, straps, or sleeves on your knee to control swelling.
  • Elevate your knee on a pillow when you’re sitting or lying down.
  • Wear a knee brace to stabilize the knee and protect it from further injury.
  • Take anti-inflammatory painkillers. Non-steroidal anti-inflammatory drugs (NSAIDs), like Advil, Aleve, or Motrin, will help with pain and swelling. However, these drugs can have side effects and they should be used only occasionally, unless your doctor specifically says otherwise.
  • Rehabilitating the knee will include stretching and strengthening exercises when you doctor recommends them. Stretching and strengthening exercises can help reduce stress to the knee if performed in a pain-free manner. Sideline Orthopedics will refer you to a physical therapist to begin a rehabilitation program.

Fortunately, most collateral ligament tears and isolated PCL tears do not require surgery. However, the ACL cannot be repaired. Once it is completely torn or stretched beyond its limits, the only option becomes a reconstruction procedure. In this procedure, tendons are taken from other parts of your leg or donor tendons are used to replace the torn ligament.

Surgical Reconstruction of ACL/PCL

Surgical reconstruction of the ACL or PCL usually involves using an autograft or donor ligament tissue. The most common grafts are autografts using part of your own body, such as the tendon of the kneecap (patellar tendon) or one of the hamstring tendons. Your doctor will discuss with you and help you decide on the best graft choice for your knee.

An alternate choice is allograft tissue, which is taken from a deceased donor. The orthopedic surgeon generally uses arthroscopic or minimally invasive surgery to repair the torn ligament in the knee. The graft is pulled through two tunnels that are drilled in the upper and lower leg bones. The surgeon secures the graft with hardware such as screws or staples and will close the incisions with stitches.

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