Knee ligament repair
Ligaments are strong, fibrous rope-like bands that hold the three bones of your knee joint together: the thighbone (femur), shinbone (tibia) and kneecap (patella). There are four primary ligaments that keep your knee bones positioned and functioning properly. Any of them can be seriously injured and require knee ligament repair:
- Collateral ligaments – The medial collateral ligament (MCL ligament) is on the inner side of your knee, and the lateral collateral ligament (LCL ligament) is on the outer side of your knee. Together they control sideway motions and keep your knee within a safe range of motion. The MCL ligament is one the most frequently injured ligaments that can require knee ligament repair.
- Cruciate ligaments – These two ligaments inside your knee joint cross one another forming an "X." The anterior cruciate ligament (ACL ligament) crosses in front, while the posterior cruciate ligament (PCL ligament) crosses in back. An ACL ligament injury is a common cause of disability in the knee. The American Academy of Orthopaedic Surgeons (AAOS) reports that 95,000 people (more women than men) get ACL injuries every year.
Painful and debilitating ligament injuries to the knee are very common in sports that require stopping and starting or quickly changing directions, and can occur when you are:
- Twisting your knee with your foot planted
- Extending your knee too far
- Jumping and landing on your knee while it’s flexed
- Stopping suddenly when you're running
- Suddenly shifting your weight from one leg to the other
A mild to moderate knee ligament injury may heal over time with nonsurgical approaches such as anti-inflammatory medications and the RICE regimen (rest, ice, compression, elevate). However, a complete tear of a knee ligament (known as a grade 3 sprain) splits the ligament into two pieces, causes the knee joint to be unstable, and can be corrected only with knee ligament repair surgery or knee reconstruction surgery.
Knee ligament repair surgery is a procedure that repairs a complete tear of one or more of the ligaments in your knee. The most advanced form of knee ligament repair surgery is a minimally invasive procedure known as arthroscopic surgery.
Knee arthroscopy surgery
The surgical procedure of choice for orthopaedic surgeons, arthroscopic knee ligament repair can be used to repair any torn ligament in the knee. According to the American Orthopaedic Society for Sports Medicine (AOSSM), more than four million knee arthroscopies are performed worldwide each year.
Your orthopaedic surgeon uses very small incisions and fiber optic technology to see inside the knee and repair the problem areas. An arthroscope is inserted in one incision, and very thin surgical instruments are inserted into one or more of the other incisions. The arthroscope is a small tube, thinner than a pencil, containing a system of lenses, a light and a small high-resolution video camera. The camera sends real-time high-definition images to a video monitor next to the operating table, thus allowing your surgeon to make precise movements with the special surgical instruments. Thanks to the miniaturized camera, your surgeon can see more detail than could be seen with a larger incision (open surgery) and the naked eye.
To restore knee stability, the torn ligament must be surgically reconstructed. Your orthopaedic surgeon will replace your torn ligament with a tissue graft. The graft will act as scaffolding on which a new ligament can grow. Grafts can be taken from several sources including:
- Patellar tendon which runs between the kneecap and the shinbone
- Hamstring tendon at the back of the thigh
- Quadriceps tendon which runs from the kneecap into the thigh
Ligament regrowth takes time, so it may be six months or more before a professional or recreational athlete can return to sports after knee ligament repair surgery.
The multidisciplinary team of knee and joint experts at Northwell Health Orthopaedic Institute performs knee ligament repair surgery as well as nonsurgical and surgical treatments for a broad range of conditions that affect the bones, joints, connective tissues, tendons and ligaments.