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Ligament Injury

Ligaments

Ligaments are dense structures of connective tissue that fasten bone to bone and stabilize the knee.
Inside the knee joint are two major ligaments

  • The anterior cruciate ligament (ACL)
  • The posterior cruciate ligament (PCL)

These cross in the center of the knee (that's why they're called cruciate ligaments) and control the backward and forward motion of the knee. The ACL is frequently injured in severe twisting injuries of the knee. Two other major ligaments are actually located outside the knee joint, on the outer and inner side of the leg. They act to stabilize the knee's sideways motion. The ligament on the inner side of the knee is called the medial collateral ligament or MCL (medial means inner side). The ligament on the outer side of the knee is the lateral collateral ligament or LCL (lateral means outer side). The two menisci act as shock absorbers within the knee and also help spread the weight load. The meniscus is a type of cartilage, though it is different than the cartilage that lines the bones. The menisci may be torn during twisting movements of the knee.

Arthroscopy is able to deal effectively with a number of problems in the knee joint.

  • Meniscal injury
  • Ligament injury
  • Loose bodies within the knee
  • Chondromalacia of the patella
  • Osteoarthritis

You will most likely have an MRI (magnetic resonance imaging) scan, which clearly will show the problem affecting your knee.

Ligament injury

Ligaments are strong bands of tissue that fasten the bone ends together and stabilize the joint.
There are two ligaments inside the knee that can be reconstructed with the assistance of the arthroscope:
The cruciate ligaments restrict both the forward and backward motion of the knee and its rotation. They may be torn by sudden twisting motions of the knee beyond its normal range.
Not all cruciate ligament injuries need to be reconstructed; it depends on your age, level of activity, type of activity, and what you expect from your knee. A frank discussion with your doctor will help both of you determine whether surgery would be beneficial.

  • If you enjoy active sports, it would be appropriate to have surgery.
  • If you have a sedentary-type job and are not active in your leisure time, you may not require surgery.

Unfortunately, a simple repair by suturing the torn ligament together again is not effective. A successful repair involves completely replacing the torn ligament. There are a number of ways to accomplish this, depending on the preference of the surgeon.

  • Ligament reconstruction is most commonly performed utilizing using the hamstring tendons from the back of the knee. The surgeon folds over these tendons four times into a strong, thick band and passes it through the knee. The advantage of this technique is that the patella tendon is left intact. There does not appear to be any damage caused to the hamstring muscles. Results using this technique are extremely good. Both of these methods require an extra skin incision (about 1 inch in length) to harvest the tendons to be used.
  • Some surgeons use the patella tendon graft. The orthopedic surgeon takes the central strip of the patella tendon and roots this through the knee through tunnels drilled in the tibia and femur. This creates a new ligament to replace the torn one.

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