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Ligament Injuries

Ligament Injuries

Ligaments are fibrous tissues which connect bones.

There are 2 main pairs of ligaments in the knee. The medial and lateral collateral ligaments run on either side of the joint and the anterior and posterior cruciate ligaments are in the middle of the joint. The patellofemoral ligament connects the patella (knee cap) to the femur (thigh bone).

Ligament injuries in the knee are common. They can occur by themselves or in connection with injuries to other structures including the menisci.

Anterior and Posterior Cruciate Ligaments

These two ligaments form an X shape in the centre of the knee joint. They prevent excess forward and backward movement within the knee and provide some rotational stability.

Damage to the cruciate ligaments are common in sport and can be associated with a sudden change of direction, direct impact to the knee or landing awkwardly from a jump.

In older patients, those with a low-grade tear or low activity levels may not need surgery. Careful rehabilitation and strengthening of the joint through physiotherapy can provide enough stability.

High-grade tears and tears in people with high activity levels often require surgical repair.

Ligament Injuries Treatment

Sometimes a repair of the ligament is possible but in many cases, the cruciate ligaments will require a ligament graft. These most commonly come from the patient’s patella, hamstring or quadriceps tendons.  Grafts using donor tissue (tissue allograft) can also be used. Your Surgeon will discuss the merits of each graft type with you.

Cruciate ligament operations are usually performed as an arthroscopic procedure (keyhole surgery).

Your Consultant will discuss all suitable treatment options with you.

Medial Collateral Ligament (MCL)

This ligament runs down the medial (inner) side of the knee and forms one side of the joint capsule. There is a connection between the MCL and the medial part of the meniscus. Injuries to the MCL are often associated with meniscal injuries.

The MCL is commonly injured skiing or in contact sports.

Treatment

See below under Lateral Collateral Ligament.

Lateral Collateral Ligament (LCL)

This ligament runs down the lateral (outer) side of the knee and forms the other side of the joint capsule. It is sometimes referred to as the Fibular Collateral ligament. Unlike the MCL, there is no connection between the LCL and the meniscus.

LCL injuries are less common than MCL injuries.

Treatment

During the first 48 hours following minor and moderate injuries to the MCL and LCL, resting and ice are advised.

If the knee hasn’t settled, the first line treatment is usually physiotherapy. Your physiotherapist can refer to a consultant if appropriate. For further information on our physiotherapy unit, visit our dedicated website www.thephysiotherapyunit.org.uk

For all major trauma to the knee, see a doctor immediately who can arrange onward referrals.

Our urgent care centre Casualty First sees all types of knee injury 7 days a week and can arrange all investigations and immediate onward referrals when required.

Appointments

If you are self-paying you don’t need a referral from your GP. You can simply refer yourself and book an appointment.

If you have medical insurance (e.g. Bupa, Axa PPP, Aviva), you will need to contact your insurer to get authorisation for any treatment and, in most cases, you will require a referral letter from your GP.

If you do not have a GP, then we have an in-house private GP practice that you can use. Alternatively we can suggest the most appropriate course of action for you to take, given your location and individual circumstance.

Our team provide a rapid access service and can sometimes provide same day appointments. Contact our Unit Coordinator on 020 7432 8328 or   londonkneespecialists@hje.org.uk to find out the first available appointment.

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