Ligament Injuries

The knee is a very stable joint not because of its bony architecture, but because of the very strong ligaments provided.

There are 4 major ligaments in the knee. 2 collateral ligaments which are on the outer side of the knee and 2 cruciate ligaments on the inside.

Ligaments give stability to the knee. The reason why our knees don’t buckle and we are able to run, jump, twist, dance is because of these strong ligaments.

These ligaments are commonly damaged during sports and accidents. The most commonly injured is the Anterior Cruciate ligament (ACL)

Symptoms

At the time of injury when the ligament breaks, it is associated with. 

  • pain
  • effusion
  • sometimes a tearing sound of ligament breaking
  • restricted ROM
  • Difficulty in walking
  • Instability

Once the acute episode subsides , instability is the only complaint in the long term.

Investigations

  • Stiffness, which means that a person experiences pain on moving the joint after an interval of rest. For eg. Standing up from a chair or stool after sitting for some time
  • Some patients also complain of morning stiffness
  • Restricted range of movement
  • Functional restrictions e.g. walking, climbing stairs, standing become painful
  • Limping and unable to squat or sit on the floor
  • Swelling of the knee may be noticed in acute episodes

Xrays

form the basic diagnostic modality and are advised routinely in all patients. Although ligaments are not seen on X-rays, but some important things to be seen on X-rays are

  • Bony avulsion injuries of ligaments
  • Arthritis if any in the knee
  • Stress Xrays to assess collateral ligament injuries
  • Any concomitant bony injury

MRI

Is the gold standard for diagnosing all ligament injuries

TIPS & INFO

Frequently Asked Questions (FAQ's)

Ligament injuries happen when the tough bands of tissue that connect bones (ligaments) are overstretched or torn — commonly due to sports trauma, falls, twists, or sudden impact.

Sprains are classified into three grades: Grade I (mild stretch, minimal tear), Grade II (partial tear, moderate instability), and Grade III (complete tear with significant instability and loss of function).

Ligament injuries are most often seen in the knee (e.g. ACL, PCL, MCL, LCL), ankle (lateral ligaments), wrist, and shoulder.

Key symptoms include pain at the time of injury, swelling, bruising, joint instability (feeling like it gives way), difficulty moving the joint, and sometimes popping sound at the moment of injury.

Diagnosis typically involves a clinical exam (checking range of motion, strength, “drawer test,” etc.), imaging like MRI to view soft tissue damage, and possibly X-rays to rule out bone involvement.

Surgery may be needed when there is a complete tear (Grade III), significant joint instability, unsuccessful conservative therapy, or when function in daily life or sports demands requires full repair.