Multi-Ligament Injuries

What is a multi-ligament knee injury? What causes it? And what can you do about it? Alexander Dodds, knee specialist for the Cotswolds, Gloucester and Cheltenham, explains.

What do the knee ligaments do?

Your knee contains numerous ligaments, which act a little like the guy ropes on a tent, helping to maintain stability and structure as you bend, twist, turn, run and jump.

Perhaps the most well-known knee ligament is the ACL (the anterior cruciate ligament), infamous for the debilitating effect injury to it can have on athletes. It forms an X (hence the word ‘cruciate’ or cross-shaped) with the PCL, the posterior cruciate ligament. Together, these ligaments hold the knee in place, stopping it sliding backwards or forwards, while the MCL and LCL (the medial and lateral collateral ligaments) prevent the knee joint slipping from side to side.

For a long time, it was thought that most knee ligament injuries involved a single ligament. We now know that’s not the case, because another ligament (the ALL or anterolateral ligament) is frequently damaged alongside the ACL.

Of the four major ligaments, however, it remains the case that most injuries are to a single ligament. Most, but not all…

>   Find out how we treat multi-ligament injuries.

What is a multi-ligament injury?

As the name suggests, a multi-ligament injury involves damage to two or more of the knee’s major ligaments. Multi-ligament injuries can be extremely serious, with almost 20% of such injuries involving some damage to blood vessels.

Read Alex’s article on the complexities of multi-ligament knee injuries (PDF), published in the Orthopaedics & Trauma Journal.

What causes a multi-ligament injury?

Some form of trauma is usually to blame for a multi-ligament injury. That might be a nasty sporting injury, but it may also be a car accident or a hard fall. If you dislocate your knee, the injury may be accompanied by a multi-ligament injury.

What are the symptoms of a multi-ligament injury?

Although you won’t know the specific diagnosis, you’ll certainly know all about the effect of a multi-ligament injury. The knee will be painful – sometimes extremely so. You’ll struggle to move the joint to its usual extent, and walking may be difficult. There may be swelling and, if blood vessels have been damaged by the trauma, you may also experience numbness or tingling in the knee.

Many multi-ligament injuries in Gloucestershire are diagnosed at A&E.

How do you diagnose a multi-ligament injury?

An MRI scan will show any damage to the soft tissues in the joint, while an x-ray will confirm if there’s any damage to the bone.

How do you treat multi-ligament injuries?

Multi-ligament injuries will almost always require surgery. Where there is damage to blood vessels, surgery should take place as quickly as possible.

>   Find out how we treat multi-ligament injuries.

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