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    Knee - Ligament Injuries

    Anterior Cruciate 
       Ligament (ACL)

    Posterior Cruciate 
       Ligament (PCL)

    Diagnosis (ACL and PCL)
    Collateral Ligaments
    Where to Seek Treatment
    Return to Knee Injuries
    Singapore General Hospital
    Contributed by Dept of Orthopaedic Surgery


    Ligament Injuries

    There are 4 ligaments, tough bands of tissues, in the knee that stablise the joint. The most commonly injured ligament is the anterior cruciate ligament (ACL).

    Preventing abnormal sideways motion of the knee are the collateral ligaments, the medial collateral ligament (MCL) and the lateral collateral ligament (LCL), which are located on the inside and outside respectively of the knee.

    1. Anterior Cruciate Ligament (ACL)


    The ACL is the most commonly injured ligament of the knee. It is usually injured in rapid or abnormal twisting motion such as when the knee stops or changes directions suddenly. The ACL can also be injured when the knee twists on landing or as a result of a direct contact or collision such as during a soccer tackle.


    • Immediate pain right after injury
    • Swelling of the affected knee within 4 to 12 hours
    • A popping sound when the ligament ruptures
    • Difficulty with knee movement
    • Walking with a painful limp
    • Feeling of instability, with the knee giving way during sports or daily activities

    2. Posterior Cruciate Ligament (PCL)


    Injury to the PCL occurs when direct force is applied to the front of the knee when the knee is bent, such as when the bent knee hits the dashboard in a car accident. The ligament may also be pulled or stretched in a twisting or hyper-extension injury.


    • Initial pain and swelling right after the injury
    • Pain in the front or inner side of the knee
    • Instability not a major complaint unless there is injury to other ligaments


    Diagnosis for ACL and PCL injuries

    Diagnosis is usually made on history and clinical examination. An x-ray of the knee will rule out associated fractures. An MRI may also be ordered to rule out other injuries to the meniscus or cartilage.

    3. Collateral Ligaments

    Injuries to the collateral ligaments, like the medial collateral ligament (MCL) and lateral collateral ligament (LCL), are usually caused by a direct blow to the side of the knee or a twisting injury. It may occur in isolation or together with ACL or PCL injuries.

    Diagnosis is usually made on history and clinical examination. Symptoms include pain and swelling at the site of injury and the knee may feel unstable.


    Treatment for Ligament Injuries

    Treatment for ligament injuries includes rest, elevation and ice therapy of the affected limb. Crutches to take some weight off the knee and braces to support the knee may also be prescribed.

    Physiotherapy to strengthen the supporting muscles and increase the range of motion will normally be part of the treatment.

    Depending on your situation, your doctor may recommend you undergo surgery for ligament repair or reconstruction.

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