Ligament reconstruction

Injuries to the Ligaments of the Knee

Anatomy of knee

Anatomy of the knee

The knee joint is a complex hinge joint .  The ligaments around and within the knee hold the joint together and prevent the joint from giving way during twisting and turning activity.

Various sporting injuries can damage the ligaments around the knee.  

The most important ligamentous injuries include trauma to the following 

  • the Medial Collateral Ligament  (MCL), 
  • the Anterior Cruciate Ligamant (ACL),
  • the Posterior Cruciate Ligamant (PCL)
  • lateral collateral ligament (LCL)
  • the Medial Patellofemoral ligament

Very often, injuries occur to knees affect combinations of ligaments, cartilages and structures, so an early assessment on the acutely injured knee is vital. 

If you have injured one of the ligaments around your knee, you will need an urgent assessment and appropriate x-rays and MRI scans. 

The earlier these injuries are picked up, the better the results are from treating it. 

The main principal of treatment of knee ligament injuries is to “diagnose the injury early, fix damaged structures expeditiously, and prevent further damage of structures doe to ongoing instability”

Once a diagnosis is made, you may require physiotherapy, bracing, protected weight-bearing and occasionally surgery. 

Many injuries can be treated without surgery if picked up early.

Anterior Cruciate Ligament Reconstruction (ACL)

The anterior cruciate ligament is an important stabiliser of the knee joint. 

It prevents the knee from giving way when you pivot and change direction during activity.

 ACL reconstructions have been performed for the last 30 years, with significant advances being made in surgery techniques. 

It is now usually done using keyhole surgery (rather than a large incision) and a variety of different graft material can be used. The most popular method of reconstructing an anterior cruciate ligament currently is the use of hamstring tendon, although alternatives include patella tendon, Allograft tissue or artificial material (Lars ligament).

Mr.Rajaratnam tends to use the patients own hamstring tendons , as these give excellent and reliable results , but he will talk you through the various options available and their merits, if you need an ACL reconstruction.

What to expect from your ACL reconstruction

Mr. Rajaratnam is passionate about rapid recovery programmes following ACL reconstructions, and has developed a number of these protocols in the hospitals he operates at.

Following ACL reconstruction, and the full course of rehabilitating, most patients will return to full sporting activity with a strong, stable and pain free knee

A long period of physiotherapy and rehabilitation is required after ACL reconstruction and it normally takes 9 months before the patient returns to full contact sports.

PCL (posterior cruciate ligament) reconstruction

The posterior cruciate ligament is an important ligament at the back of your knee. 

You can injure your posterior cruciate ligament if your knee sustains a head-on blow (for example in a motorbike accident or a rugby injury).

A PCL injury may be treated with bracing and physiotherapy in a number of instances, but occasionally , a Grade 2 or Grade 3 PCL injury may need a surgical reconstruction.

What to expect from your PCL reconstruction

Mr. Rajaratnam does PCL reconstructions via a Keyhole technique, and often uses the patients hamstring tendons or allograft material to reconstruct the PCL. 

Like an ACL reconstruction, and PCL reconstruction will need an extensive physiotherapy programme to get the patient back to peak fitness.

Medial Collateral Ligament injuries (MCL)

Most isolated MCL injuries can be treated conservatively with Bracing and Physiotherapy, as the vast majority heal very well without surgery.  

It is therefore important to diagnose these early, and soon after the injury occurs.

MCL injuries can also occur in combination with Meniscal tears and ACL injuries, which will need careful management.  Mr.Rajaratnam will carefully guide you through the appropriate rehabilitation and surgical programme, to enable optimal recovery of your knee in each pattern of injury.