Knee meniscus and ligament injuries (ACL, PCL injuries)

Sports medicine has come a long way with athletes being injured regularly but returning to sports at a rate which was never seen before. Read on to find more about the latest innovation in this field.

Knee is a complex synovial joint held together by 2 menisci and 4 ligaments & is the most commonly injured joint during sport activities. Let's take a closer look into the various injuries related to knees.

What are Meniscal Injuries ?

Meniscus, medial and lateral meniscus act as the shock absorber in the knee joint and protect the cartilages of the bones forming the knee joint. These menisci may tear during athletic activities or even during day to day activities. A tear in the meniscus will result in severe pain, swelling and loss of range of motion of the knee. Diagnosis is confirmed by clinical examination and MRI of the affected knee. Treatment algorithm for meniscus injury is as follows

1. RICE (rest, ice, compression, elevation)

2. Oral anti-inflammatory medication

3. Physiotherapy

4. Local corticosteroid injections

5. Meniscectomy Arthroscopy surgery

6. Meniscus repair Arthroscopy Surgery

Arthroscopy of the knee involves putting an arthroscope or camera in the knee and doing a key hole surgery through 2 or 3 small incisions. Meniscus tear may require either cutting out the torn part of the meniscus (meniscectomy) or repairing the torn meniscus (meniscal repair surgery) based on the nature of the tear.

What are Ligament Injuries ?

The knee is held together by 4 ligaments as described below

• ACL(prevents forward translation of the knee)

• PCL(prevents backward translation of the knee)

• MCL(prevents inward translation of the knee)

• LCL (prevents outward translation of the knee)

Injury to one or more of the above ligaments is common during sporting or athletic activities. If one of the ligaments in the knee is torn, the knee becomes unstable in that particular direction eg if ACL is torn, the knee starts to give way with the femur moving forward on tibia.

Ligament injury manifests as the patient being unstable on knee and the knee giving way or bucking in episodic fashion leading to pain, swelling and restriction of range of motion. Diagnosis is generally quite evident by history and confirmed by clinical examination and MRI scan of the knee.

In a young individual, conservative treatment of ligament injury has limited role and the condition generally requires Arthroscopic Ligament Reconstruction where an artificial ligament is formed through key hole surgery. This may involve either using your own tendon or artificial graft in place of the ligament. Physiotherapy both before and after surgery is paramount to achieve good results.