Torn cruciate ligament/knee ligament: diagnosis, surgery and recovery

An injury to one of the cruciate ligaments of the knee is considered one of the most serious injuries in sports, often worse than a broken bone. Such a rupture can also hinder you in everyday life. A strained cruciate ligament recovers relatively quickly, but a torn or torn cruciate ligament will require you to undergo rehabilitation for at least 6 months. In the case of a torn cruciate ligament, surgery is necessary to restore the stability of the knee.

Injury to the knee ligaments

  • The ligaments in the knee
  • Diagnosis torn knee ligament
  • After surgery: recovery 6 to 9 months
  • Knee brace after surgery

The ligaments in the knee

Your knee contains several bands or ligaments that keep the bone structures together and therefore the stability of the knee. The most important tires are the following:

  • Anterior cruciate ligament ( ligamentum cruciatum anterius ): runs from the inner back of the outer epicondyle of the thigh to the top of the tibia.
  • Posterior cruciate ligament ( ligamentum cruciatum posterius ): runs from the inner front of the inner epicondyle of the thigh to the outer rear of the tibia.
  • Outer knee ligament ( ligamentum collaterale fibulare ): runs between the outside of the thigh ( epicondylis lateralis femoris ) to the outside of the fibula ( caput fibula ).
  • Inner or medial knee ligament ( ligamentum collaterale tibiale ): runs between the inside of the thigh ( epicondylus medialis femoris ) to the inside of the shin bone.

Diagnosis torn knee ligament

Torn anterior cruciate ligament

There are certain external features of the knee that immediately lead an expert to suspect that there is a tear in the cruciate ligament. For example, an inward-facing, bent-outward position of the knee and immediate swelling are indicators of an injury to the anterior cruciate ligament. When the injury occurs, a snapping sensation is often experienced, literally as if something is loosening inside the knee. To test the hypothesis that this is indeed the case, the Lachmann test is often used to test the forward and backward stability of the joint. If this has decreased abnormally, a pivot shift (rotational instability test) is done. This test is not always possible due to swelling that can obstruct the meniscus and knee capsule. In any case, a positive result should assume damage to the anterior cruciate ligament, but it is impossible to say what type of damage it involves. An MRI scan or keyhole surgery is necessary for this.

Torn posterior cruciate ligament

posterior cruciate ligament tears, the symptoms are often less severe. Pain and swelling will be somewhat less. There is often a ‘sagging feeling’, the feeling of the knee sagging when changing the direction of walking. Anyone who participates in sports at a high level will have to undergo surgery for this. If this is not the case, a decision will be made whether or not to proceed with surgery based on the degree of instability of the knee. This is determined by means of the so-called ‘rear sliding drawer test’.

Torn outer knee ligament

An isolated torn outer knee ligament is rare. This band is thin but very strong and only tears when enormous force is exerted on it. When this ligament tears, many other structures of the knee are usually also affected, such as the meniscus and the cruciate ligaments. Outer knee ligament injuries are almost never treated surgically, except in top athletes.

Torn inner or medial knee ligament

Injury to the inner knee ligament only occurs when great force is exerted on the outside of the knee. The inside of the knee can be pushed apart, causing great pressure on the inner knee ligament. This can lead to a tear in the middle or at the attachment of the band to the bone. It is common in football players and skiers. Symptoms include pain and swelling on the inside of the knee and a feeling of instability. Outer knee ligament injuries are almost never treated surgically.

After surgery: recovery 6 to 9 months

If it has been determined that it is a torn anterior or posterior cruciate ligament, it must be repaired surgically. Physiotherapy is very important afterwards. After surgical reconstruction it is often difficult to straighten the leg. It is as if the entire control mechanism of the leg has been disrupted, meaning that you cannot operate the correct muscles. First the swelling will have to disappear, so you will need to rest a lot in the first few days.

  • In the first 8 to 10 weeks it is therefore recommended not to exert more than 50%.
  • In the second phase of approximately 6 weeks, strength training and exercises that promote movement, symmetry and rhythm can be started.
  • In the third phase of approximately 12 weeks, you must gradually return to normal activities. At the end of this period, the knee is expected to be optimal again, and rapid twisting and turning should no longer cause problems.

When top athletes suffer a knee ligament tear, an estimated recovery time is often said to be 6 to 9 months. These are 6 months to allow the knee to fully recover and 3 months in which strength is built up again and competition rhythm is acquired so that you can perform at a top level again without danger to the knee joint. However, many people still face setbacks during this period. An inflammatory reaction may still occur in the knee or injuries may occur in other places in the body as a result of overload, such as in the hamstring, groin or calf.

Knee brace after surgery

Amateur athletes and recreational athletes who have suffered a cruciate ligament injury and then return to sports often use a knee brace that can support the knee and provide extra stability. This is not just a simple neoprene sock, but a hinged brace or one with medial and lateral stays that can help prevent you from overextending the knee and sustaining the same injury again. People with additional insurance may be able to receive (partial) reimbursement for the brace.

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