Understanding Knee Ligament Injuries in Young Adults
Knee injury in a young person is very common, due to their active lifestyle, involvement in sports, gym and sudden physical exertion.
The spectrum of injury can vary from a minor sprain (where the ligaments/supporting tissues around the joint are stretched), to complete knee dislocation (where the joints that make up the knee, gives away), which can even be limb-threatening.
Types of sprains
In First degree and Second degree sprain, the ligament fibres are stretched or partially injured. These are considered minor and can be treated with Rest, Ice packs, Compression Bandaging, and Elevation of the injured limb (RICE) along with a few anti-inflammatory medications. However, third degree sprains are complete tears of the supporting structures/ligaments, which require active medical attention and treatment.
Multiligament Injuries
The Knee has four ligaments. Therefore, if the injury is very severe, sometimes more than one ligament — two or even three can be injured. Such cases are called Multiligament Injuries, which are serious forms of knee injury, requiring immediate attention in a hospital set-up.
Rest and Physiotherapy
For first degree and second degree sprains, a period of 4–6 weeks of proper rest to the affected joint is recommended for an uneventful recovery. Physiotherapy remains the mainstay of management while the person recovers during this period. It initially aims to reduce the pain and swelling in the joint, followed by gradually improving the functional status of the injured joint.
Diagnosis and Surgical Need
In third degree sprains, the injured limb needs to be carefully evaluated by a specialist Orthopaedic doctor. After being immobilised in a knee brace, further investigations like an MRI (Magnetic Resonance Imaging) may be required to assess the structures involved in injury. If the ligaments inside the knee joints such as ACL or PCL- are found to have more than 50% torn on MRI, usually have a poor chance of healing spontaneously. After a waiting period of around 3–4 weeks, during which physiotherapy continues, the doctor may advise a ligament reconstruction surgery.
Sportspersons involved in contact sports like football, martial arts often suffer from ligament injuries of the knee. There are also documented cases of individuals returning to near pre-injury level of sports, after undergoing the procedure.
With the availability of knee ligament injury specialist in Guwahati, The Department of Orthopaedics at GNRC Hospitals, Dispur, have been performing Arthroscopic Reconstruction Surgery of ACL, PCL, multiple ligament injuries of knee joint since 2016, with a very satisfactory outcome and positive ACL surgery reviews.
The procedure is mostly performed under spinal anaesthesia, along with which, our skilled anaesthetist also instils regional nerve blocks for complete pain control, the effect of which lasts for around 12–14 hours post-surgery. Usually, a one night hospital stay is sufficient.
Physiotherapy is initiated the next morning, and the patient is mobilised with toe touch or partial weight bearing using axillary crutches, which includes the ability to walk to the toilet. After discharge, patients are seen on a regular outpatient follow-up and physiotherapy is gradually increased, until recovery is complete. Complete return to sports or heavy activity is allowed after at least six months.
When to Visit an Orthopaedic Surgeon
Consult Dr. Gautam Rava, Orthopaedic Doctor at GNRC Hospitals, Dispur for expert evaluation of knee ligament injuries and if you experience:
- Persistent knee pain after an injury
- Feeling of instability in the knee
- Swelling or inability to bear weight
- Suspected ligament tear based on MRI or clinical signs
1. What are the symptoms of a knee ligament tear?
Symptoms of ligament tear usually include sudden pain, swelling, instability of the joint, and difficulty in walking or bearing weight. In severe cases, you may even hear a "pop" sound at the time of injury. If you experience these symptoms, it’s best to consult an orthopaedic specialist immediately.
2. When should I see a doctor for a knee sprain or ligament injury?
You should see an orthopaedic doctor if your knee pain doesn’t improve after a few days, if the swelling gets worse, or if your knee sometimes feels like it might suddenly collapse or can’t support your weight. An orthopaedic specialist can evaluate whether it is a minor sprain or a more serious ligament tear that may require imaging like MRI or surgical intervention.
3. What is the difference between ACL and PCL injuries?
The ACL (Anterior Cruciate Ligament) and PCL (Posterior Cruciate Ligament) are the key stabilizers of the knee. ACL injuries are more common and usually occurs with twisting or sudden stopping movements, while PCL injuries often result from direct impact. Both ACL and PCL can be partially or completely torn and may require arthroscopic surgery if the damage is severe.
4. How is knee ligament reconstruction surgery performed?
Ligament reconstruction is done through arthroscopy, a minimally invasive keyhole surgery. A small camera and surgical tools are inserted through a small incisions to repair or reconstruct the torn ligaments using a tendon graft, which is often harvested from the patient’s own thigh (semitendinosus tendon).
5. How long does it take to recover after ACL or PCL surgery?
Recovery time varies for individuals, but typically, full recovery after ACL or PCL reconstruction takes approximately 6 months. Physiotherapy or rehabilitation starts the day after surgery. Athletic activities and heavy physical activity can only be resumed after a structured rehabilitation programme is completed.
6. Can ligament injuries heal without surgery?
Minor ligament sprains (Degree 1 or 2) generally heals with rest, physiotherapy, and supportive care (RICE method). However, Degree 3 sprains or multiligament injuries usually don’t heal on their own and may require surgical reconstruction, especially if the ACL or PCL torn is more than to 50%.
