Knee ligament repair/ reconstruction

You may have noticed some instability in your knee joint, severely limiting your flexibility and range of movement. A common cause of this is a torn ligament in the knee, and without medical intervention, this can cause further problems for you in the future.

There are four main ligaments in the knee that connect your femur (thigh bone) to your tibia (shin bone):

  • ACL (Anterior Cruciate Ligament) – Centre of the knee, controls rotation and helps limit forward movement of tibia,
  • PCL (Posterior Cruciate Ligament) – Centre of the knee, helps limit backwards movement of tibia,
  • MCL (Medial Collateral Ligament) – Supports the inner knee,
  • LCL (Lateral Collateral Ligament) – Supports the outer knee.

Any of your ligaments can tear if extreme stress or strain is placed on the knee, as your ligaments are unable to cope with the added pressure. Tears are often linked to sports or to a direct impact, and different types of strain can result in a different ligament being torn.

ACL injuries are some of the most common, as your ligament can be stretched or torn during the sudden twisting motions that occur when you play sports such as football, basketball, or hockey.

PCL tears tend to be as a result of a direct impact, such as a car accident or a hard football tackle, as are tears to the two collateral ligaments.

Symptoms for a knee ligament tear can vary, depending on the time since your injury occurred. For an ACL or PCL tear, pain and rapid swelling are likely, and in many cases, you may hear and/or feel a pop. You will usually be able to identify which ligament has torn based on the location of the pain and swelling.

During the first few weeks after the injury, your level of pain and swelling should start to reduce, but your knee may become increasingly stiff and you will feel some weakness and instability in the knee joint.

Beyond this timeframe, your knee joint may continue to be unstable and you may have the sensation of your knee ‘giving way’ as well as recurring pain.

During your first appointment, your doctor will take a history of your condition and examine the injured knee. This examination focuses on movements to isolate each ligament in turn to highlight the type of tear.

You may also be referred for an x-ray or other diagnostic scan, largely to check if any other issues are present, such as a fracture or cartilage damage.

If the injury was suffered recently, you will be encouraged to rest, and to treat any swelling by applying an ice pack to the affected area. You may be advised to wear a protective knee brace to help support the injured joint during light exercise, and your doctor will likely prescribe pain medication to help make you more comfortable.

Our dedicated physiotherapy team will work closely with you, supervising your rehabilitation with a specific program tailored towards your recovery, ensuring the appropriate exercises are used depending on the phase of your rehabilitation.

Non-surgical measures aren’t always appropriate, however, especially if you have a complete ligament tear. If your knee continues to give way and feel unstable after a course of physiotherapy, our consultants may suggest surgery as the best option for you.

As before, you will be assessed by our orthopaedic team prior to surgery, and further x-rays and diagnostic scans may be taken. You will be assigned an anaesthetist who will administer a general anaesthetic and monitor you throughout your surgery.

A knee ligament repair is a common procedure that typically takes between 60-90 minutes. Your surgeon will use a form of keyhole surgery known as arthroscopy, making an incision in your knee and inserting the arthroscope (a thin tube with a light and camera attached to it), allowing your surgeon a clear view of the joint.

At this point, the torn ligament will be removed and a replacement tendon, often from your kneecap, hamstring, or an organ donor, will be used to reconstruct the ligament. Screws or staples will then be used to hold everything in place, and the incision in your knee will be stitched together.

It will likely take a few weeks before you can resume your normal routine, and you will need to rest as your knee recovers. Once any swelling has reduced, our physiotherapists will continue to work with you as you begin to build up strength, until you have reached full mobility.

If you think you are in need of a knee ligament repair, Circle Health is the obvious choice for consultation and surgery. You will be seen by some of the leading orthopaedic surgeons in the country, as well as a highly skilled, multi-disciplinary team to oversee your recovery, all of whom will ensure that you get the best possible treatment along the way.

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Circle Health Group, 1st Floor, 30 Cannon Street, London, EC4M 6XH