Ligament Reconstruction
Anterior Cruciate Ligament (ACL) Injuries
The anterior cruciate ligament or ACL is one of the most common injured ligaments of the knee, especially in sports such as basketball and football. The ACL stabilizes the knee for cutting, twisting and jumping and pivoting activity. The anterior cruciate ligament is in the center of the knee joint.
When you tear an ACL, you will often feel or hear a pop. You will also feel the knee shift out of place and develop significant swelling in just a few hours. The initial treatment should consist of ice to the knee, leg elevation and crutches. A sports physician, orthopaedic surgeon or physiotherapist should evaluate the injury.
If the ACL has been torn, surgical reconstruction of the ligament may be indicated, as the ligament rarely heals by itself.
Posterior Cruciate Ligament (PCL) Injuries
The posterior cruciate ligament (PCL) in the back of the knee helps control posterior movement of the tibia under the femur. PCL tears occur when this stabilizing ligament is stretched beyond its limits, usually due to a high-energy force on the front of the bent knee. As a rule of thumb, it is usually not as disabling as ACL injuries.
Symptoms of a PCL tear include posterior knee pain, swelling, difficulty fully extending the knee and instability with posterior tibial movement. Patients may also feel like their knee wants to "give out" backward. Most PCL injuries can be treated with physiotherapy except for very severe tears, which may require surgery.
Medial Collateral Ligament (MCL) Injuries
The medial collateral ligament (MCL) on the inner side of the knee helps stabilize the joint and limit excessive motion. MCL tears occur when this ligament is overstretched or torn, usually due to a blow or sudden twist to the outer knee.
Symptoms of an MCL tear include pain and tenderness along the inner knee, instability, difficulty fully bending or straightening the leg, and swelling. Minor sprains may heal on their own in a brace with rest, ice, compression, and elevation (RICE). Grade 2 and 3 MCL tears require rehabilitation and possibly surgery.
Ligament Reconstruction Surgery
In ligament reconstruction, the surgeon removes the torn ligament and replaces it with a graft, typically harvested from the hamstring tendon, patellar tendon, or cadaver tissue. The graft is secured to the femur and tibia bones to recreate the function of the damaged ligament. This restores knee stability and limits abnormal joint motion.
The goals of knee ligament reconstruction are to:
Relieve pain and instability
Restore normal knee function
Allow a gradual return to regular activities and sports
Reduce the risk of developing early osteoarthritis over time
Post-surgical rehabilitation
After surgery, patients undergo a lengthy course of physical therapy.
In physical therapy, exercises focus on reducing inflammation, regaining range of motion, and strengthening supporting muscles. Bracing may be needed to stabilize the knee during recovery. For severe tears, surgery involves repairing the ligament using grafts or tightening it to the bone. Patients would need to undergo intensive post-op physiotherapy to regain knee function. Proper rehabilitation is key to return to prior activity levels with a repaired MCL.
With proper treatment, most patients can regain full knee function after a ligament injury. But preventing reinjury and strengthening the knee long-term can help avoid future complications.
Consult our orthopaedic surgeon Dr Sean Leo on your ligament injury to get an assessment on your condition and the appropriate treatment plan for you.