The knee is stabilized by several tissue ligaments. These can tear or rupture as a result of a sports injury or accident. This leads to severe pain and often to knee instability.
Below you will find further information and selected specialists for torn knee ligaments.
The ligamentous apparatus of the knee consists of
The fibrous connective tissue cords, which are not very stretchy, stabilize the knee joint with every movement.
The following video provides an overview of the structure of the knee joint:
The outer ligament of the knee only tears extremely rarely, whereas the inner and cruciate ligaments can be damaged more quickly. A combination of ligament tears is also common, in which several ligaments are affected by the injury.
If the
is also referred to as an"unhappy triad".
The knee joint is stabilized by several ligaments © bilderzwerg | AdobeStock
In most cases, knee ligaments tear during sport. People who play sports with lots of quick changes of direction are particularly at risk. In addition to soccer and squash, this also includes handball.
This can lead to so-called rotational trauma, in which the knee rotates and the lower leg remains fixed. This puts so much strain on the ligaments that they can no longer withstand it and tear. The posterior cruciate ligament of the knee in particular is then damaged.
Traffic accidents or falls can also damage the ligaments. Researchers also assume that there is a genetic predisposition to knee injuries. Previous knee injuries also increase the risk of a torn knee ligament.
At the immediate moment of the accident, those affected feel acute and severe pain. Some patients report a tearing sensation or a "shifting feeling" in the knee. The tear is sometimes even clearly audible as a popping sound.
The exact location of the pain depends on which structure in the knee is affected. The pain caused by a torn anterior cruciate ligament is severe, but subsides after a short time. Any strain causes pain again.
The knee is also clearly unstable and wobbles. This is particularly noticeable when climbing stairs. Here, the thigh shifts backwards in relation to the lower leg. People who have suffered a torn posterior cruciate ligament can often compensate well for the instability if they bend their knees slightly when walking. Typically, the pain is felt in the front area and occurs mainly when sprinting or braking.
A torn medial collateral ligament is characterized by severe pain and swelling on the inside of the knee. As small blood vessels are often also injured here, a haematoma forms. As with cruciate ligament tears, the knee is unstable due to the ligament injury.
In the case of a torn collateral ligament, there is usually pressure pain in the area of the torn ligament. The knee is unstable due to
can no longer bear weight.
The description of the course of the accident and the subsequent symptoms alone indicate to the doctor that the ligaments are torn. For a reliable diagnosis, however, the knee joint must be examined in detail.
To do this, the doctor uses various stability tests to check whether the joint has an abnormally large range of motion.
The so-called Lachman test and the drawer test are used to rule out cruciate ligament ruptures. If the lower leg can be displaced forwards or backwards to an unnatural extent compared to the thigh in this test, a so-called drawer phenomenon is present.
However, the range of movement differs from person to person. The doctor therefore always tests both sides in order to compare the affected knee with the healthy knee.
Imaging procedures such as
can also confirm the diagnosis. They also serve to rule out complications such as injuries to the bone or other joint structures.
If a joint effusion has formed as a result of the accident, the doctor can puncture the knee to relieve the pressure and remove fluid with a hollow needle. The puncture can be examined in the laboratory and also provides information on the cause. If blood is found in the fluid removed, this indicates a torn ligament.
Initial treatment is important for a torn ligament. The PECH rule should be applied here:
These measures limit the damage after a sports injury or accident.
In further therapy, the torn ligament can be treated either conservatively or surgically. In conservative therapy, patients are given a (movable) splint. They stabilize the joint and absorb stress until the injury has healed.
Pain-relieving, decongestant and anti-inflammatory medication can also alleviate the symptoms.
If the knee joint no longer has sufficient stability or if the injury is complicated and extensive, surgery may be necessary. The surgical procedure is usually minimally invasive and can be performed on an inpatient or outpatient basis.
The surgeon replaces the torn ligament with a new ligament made from materials foreign to the body or the body's own (ligamentoplasty). For example, healthy tendons from the patient's leg muscles are used for this. The video shows how a ligament repair for a torn cruciate ligament is performed:
Physiotherapy can promote healing both during conservative treatment and after surgery. Special exercises are designed to restore the stability of the knee joint and get the joint used to everyday stresses and strains.
The prognosis depends on
treatment.
If the tear is treated immediately, the chances of a quick and uncomplicated recovery are good. When exactly the knee is ready for use again should be discussed with the doctor treating the patient.
However, it can generally take up to a year before the knee is fully fit for sport again and able to withstand all loads.
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