Ligament Injuries (ACL/PCL/MCL/LCL)
What is it?
-
There are 4 main ligaments that help to provide stability in the knee joint. These are: anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL).
Typical Symptoms/features:
-
For all these ligaments, injury is usually a result of trauma to the area. There may be an audible “pop” at the time of injury. There is usually a sudden onset of pain, swelling and/or bruising. It may be painful or difficult to weight bear initially and the knee may not bend or straighten all the way. Feelings of knee instability are common with these injuries. Please see below for specifics related to each ligament:
ACL -
-
ACL injury often occurs during sports when the foot is planted and a sudden force hits the knee whilst the leg is straight or slightly bent. This can happen with sudden changes of direction, slowing down when running, or landing from a jump. It is common in sports such as football, skiing and rugby.
PCL -
-
Posterior Cruciate Ligament (PCL) tears are less common than ACL injuries.
-
There is usually less swelling and pain compared to an ACL injury.
-
PCL injuries are often due to a blow to the shin whilst the knee is bent e.g. striking the knee against the dashboard during a car accident or falling whilst the knee is bent during sport.
MCL/LCL -
-
The Medial Collateral Ligament (MCL) is located on the inside of the knee and can be injured with force to the outside of the knee.
-
The Lateral Collateral Ligament (LCL) is located on the outside of the knee and can be injured with high energy direct forces to the inside of the knee.
Management:
-
Activity modification
- When you first have an injury to a ligament, you may need to reduce your activities to allow pain to settle. However, gentle movements as pain allows can be beneficial.
-
Ice or heat
-
Pain relief
-
Physiotherapy including range of movement exercises and a graded strengthening programme.
-
Orthopaedic options- Depending on different personal factors, these injuries can be managed either surgically or non-surgically. It may be appropriate to have an early orthopaedic surgical opinion if you have a highly active lifestyle/career or regularly engage in sports. However, in most cases, conservative treatment is trialled for 3-6 months as first line treatment.
Do I need imaging?
-
An MRI is used for diagnosis in those wanting to consider surgery.
