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You may have noticed some instability in your knee joint which severely limits your flexibility and range of movement. This is commonly caused by a torn ligament in the knee. Without medical intervention, knee ligament damage can cause further problems for you in the future.
There are four main ligaments in the knee connect your femur (thigh bone) to your tibia (shin bone):
- The Anterior Cruciate Ligament (ACL) is at the centre of the knee and controls rotation and helps limit forward movement of the shin bone
- The Posterior Cruciate Ligament (PCL) is at the centre of the knee and helps limit backwards movement of the shin bone
- The Medial Collateral Ligament (MCL) supports the inner (medial) ligament of the knee
- The Lateral Collateral Ligament (LCL) supports the outer (lateral) ligament of the knee
A knee ligament tear or injury can occur if extreme stress or strain is placed on the knee. The ligaments are unable to cope with the added pressure and the tissue can tear. These injuries are often linked to sports or to a direct impact of the leg. Different types of knee ligament strain can result in a different ligament being torn. ACL injuries are some of the most common injuries, as your ligament can be stretched or torn during the sudden twisting motions that occur when you play sports such as football, basketball or hockey. ACL surgery is a very common procedure.
PCL tears tend to be as a result of a direct impact, such as a car accident or a hard tackle when playing football.
Tears in the collateral ligaments of the knee, are also usually caused by an impact to the leg. Such an impact can result in MCL tears or LCL injury.
Although, physiotherapy can help with minor damage to a knee ligament, non-surgical measures are not always appropriate when treating a damaged knee. If your knee continues to give way and feel unstable after a course of physiotherapy, our consultants may suggest surgery as the best option for you.
During your first appointment, your doctor will take a history of your condition and examine the injured knee. This examination focuses on movements to isolate each ligament in turn to highlight the type of tear.
The Consultant may also refer you for an x-ray or other diagnostic scan. This is to check if any other issues are present, such as a fracture or cartilage damage.
If the injury was suffered recently, you will be encouraged to rest, and to treat any swelling by applying an ice pack to the affected area. You may be advised to wear a protective knee brace to help support the injured joint during light exercise. Your doctor may also prescribe pain medication to help make you more comfortable.
The symptoms for a knee ligament tear can vary, depending on the time when your injury occurred. For an ACL or PCL tear, knee ligament pain and rapid swelling are likely, and in many cases, you may hear and/or feel a pop. For collateral ligament injuries, you will feel pain in the joint capsule and swelling of your knee.
You will usually be able to identify which ligament has torn based on the location of the pain and swelling.
During the first few weeks after the injury, your level of pain and swelling should start to reduce, but your knee may become increasingly stiff and you will feel some weakness and instability in the knee joint ligaments.
Beyond this timeframe, your knee may continue to be unstable and you may have the sensation of your knee ‘giving way’ as well as recurring pain.
The cost of this treatment varies between locations. It also depends on other important factors, such as:
- Which Circle hospital you receive treatment in;
- The reason why you are getting this treatment, and
- Your individual healthcare needs.
The cost includes all your hospital visits, such as initial consultation, the surgery and recovery afterwards when you are an inpatient. We provide high-quality care throughout and we reflect that within our costs.
We also understand that your treatment needs to be tailored to your needs, both physical and emotional. This no one-size-fits-all approach means that the cost of knee replacement surgery often varies from person to person.
Our orthopaedic team will assess your knee injury prior to surgery. The consultant may then take further x-rays and diagnostic scans. You will be assigned an anaesthetist who will administer a general anaesthetic and monitor you throughout your surgery.
A knee ligament repair surgery is a common procedure that typically takes between 60-90 minutes. Your surgeon will use a form of keyhole surgery known as arthroscopy. During the procedure, a small incision is made in your knee. An arthroscope (a thin tube with a light and camera attached to it) is then inserted. This allows your surgeon to see inside the knee joint.
At this point, the torn ligament will be removed and a replacement tendon, often from your kneecap, hamstring, or an organ donor, will be used to reconstruct the ligament. Screws or staples will hold everything in place. The incision in your knee is then stitched together.
It will take a few weeks before you can resume your normal routine, and you will need to rest as your knee recovers. Once any swelling has reduced, our physiotherapists will continue to work with you as you begin to build up strength, until you have reached full mobility.
After having reconstructive surgery, a few people may still experience knee pain or instability.
Recovering from surgery usually takes around six months, but it could be up to a year before you're able to return to full training for your sport.
Our dedicated physiotherapy team will work closely with you, supervising your rehabilitation with a specific physical therapy program tailored towards your recovery. The physiotherapist will ensure the appropriate weight-bearing exercises are used depending on the phase of your rehabilitation.
As with any surgery, there are some risks. These include:
- There is a small risk of infection
- blood clots – if your consultant believes you to be at risk then you may be given medication to prevent them forming
- knee pain when kneeling or crouching
- knee weakness and stiffness
