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Multiligament knee injury

Under the general classification of knee trauma, there is knee damage caused by external trauma (e.g., accidents, falls or injuries sustained during sports) which results in distorted external ligaments such as the medial collateral ligament (MCL) and lateral collateral ligament (LCL), distorted internal ligaments such as the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) or meniscus tear. MCL and/or ACL injury can occur when the knee is struck hard on the side while the foot is firm on the ground. An ACL and LCL injury can occur when an outward force is applied to the knee. The injuries are classified as First Degree when only a small part of the fibrous tissue is torn; Second Degree when 50% or more of the fibres are damaged; and Third Degree when the ligament is completely ruptured.

Age group

Knee trauma can affect all age groups, but athletes and workers who have to constantly endure excessive load to the knee are more affected.

Anatomy of the ligaments

Ligaments are bands of connective-fibrous tissue which join the ends of two bones or two parts of the same bone. In the knee, there are four main ligaments: the lateral and the medial ligaments which prevent excessive lateral movement of the knee; and two cruciate ligaments, anterior and posterior, which form an X in front of and behind the knee and enables the movement of the knee. Their job is to stabilize the joint and prevent the bone components from losing their proper alignment.

Symptoms

When a ligament is torn, the pain is immediate, localized and acute. The knee ‘snaps’, followed by a feeling of sagging, swelling and difficulty in walking.

When should you call a doctor?

As soon as possible in order to assess the extent of the damage.

Diagnostic tools

An accurate clinical evaluation is required to identify the location of the ligament damage such as a radiography exam to rule out fractures and/or an MRI to assess the extent of ligament damage. These exams will help to formulate a treatment plan.

What to do in the meantime?

Keep the knee at rest, walk with the help of a cane or crutches based on pain level, apply ice (not in direct contact with the skin), take painkillers, and stabilize the joint with a knee brace if the feeling of instability is not tolerable.

Conservative therapies

For mild and moderate injuries, the protection protocol is implemented (rest, ice, compression, and gentle lifting of the leg), and if necessary, the usage of a brace is recommended to immobilize the knee with the use of crutches over a period to be evaluated by a specialist.

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