KNEE Tendonitis

Disease awareness page for R3 stem cell – knee tendonitis

What are knee ligament injuries?

A ligament is a tough, elastic band of tissue that attaches bones together, fixing them in place and limiting their movements, but providing stability and strength. A knee ligament injury is a sprain to any or a combination of the ligaments of the knee. There are four ligaments in the knee, and they are differentially prone to injury. Injury may be a sprain or tear. They are namely: anterior cruciate ligament – ACL, posterior cruciate ligament – PCL, lateral collateral ligament – LCL, and medial collateral ligament – MCL.

Anterior cruciate ligament, ACL injury: ACL connects the thigh bone or femur to the shin bone or tibia on the inside, in front of the knee. It is the most commonly injured ligament of the knee. It prevents the shin bone from sliding in front of the thighbone, and also controls the rotation of the knee. Injury to the ACL occurs when it is stretched or torn by a force directed at it from the front or back.

Posterior cruciate ligament, PCL injury: PCL connects the thigh bone or femur to the shin bone or tibia, on the inside, but behind the ACL. It is the least likely to be injured as it is the strongest ligament of the knee. It controls the backward motion of the knee, and it is often called an overextended knee. Injury to the PCL occurs when it is stretched or torn by great force to the knee, for example in an accident.

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Lateral collateral ligament, LCL injury: LCL connects the thigh bone to the fibula on the lateral side – outside – of the knee. It provides stability to the outside of the knee. An LCL injury occurs when the ligament is torn or stretched by a force directed at the knee from the sides.

Medial collateral ligament, MCL injury: MCL connects the thigh bone to the shin bone on the inside of the knee. It provides stability to the inside of the knee. Injury to the MCL occurs when the ligament is stretched or torn by a force directed at the knee from the sides.

Knee ligament injuries are a very common occurrence in sports. They can happen in quite a number of ways, either from badly landing a jump or from a blunt force directed at the knee, as occurs in a tackle. Knee ligament injuries can also occur in situations outside of sports, like in a car crash or bike accident.

There are three levels of severity to all types of knee ligament injuries. These levels are:

Grade I sprain. Also referred to as mild sprain, is the least severe form of injury. It occurs when the ligament involved is stretched but not torn. The stability of the knee is not particularly affected, however, it should still be treated as it can increase the tendency of a repeat injury.
Grade II sprain. Also referred to as moderate sprain, occurs when the ligament affected is partially torn. This causes swelling, pain, and makes movement difficult.
Grade III sprain. Also referred to as severe sprain, results when there is a total tearing of the ligament. The knee becomes unstable and unable to bear weight.

How prevalent are they, and who is at risk?

Any one is prone to having knee ligament injuries as you can’t predict when it will happen if it is going to happen. However, the following factors can put you at a higher risk of spraining or tearing any ligament of your knee joint.

Age. As you grow old, the ligaments naturally become weaker, increasing the likelihood of you spraining them.
Being pregnant. As you usually put on weight during this period. Also the center of gravity of the body is altered. Hormonal changes can weaken the ligaments making them liable to spraining.
If you engage in sports like football, soccer, basketball etc.
If you are overweight or obese, there is a higher chance of you spraining your knee ligaments due to excess weight.

What are the symptoms of ligament injuries?

The symptoms of knee ligament injuries are dependent on the extent of injury. The following are the symptoms you may experience:

Decrease in the range of motion of the knee
Redness and swelling
Putting weight on the leg becomes difficult
A feeling of looseness in the knee
Pain and tenderness in the region of the affected ligament

A popping sound may be heard in case of a severe grade III sprain
A popping sound may be heard in case of a severe grade III sprain
Bleeding can occur in severe grade III sprain
Occasionally, no pain is felt, because the pain receptors are severed in severe grade III sprain

How are they diagnosed?

To diagnose knee ligament injuries, a doctor, usually, will carry out a physical examination by inspecting the bones of your knee, making sure they are in the right place. But prior to inspecting your knee, he will quiz you about your medical history to know if you have had any previous medical condition, or medication that may affect the knee. He may ask you to narrate your experience if the symptoms are as a result of an accident. He will ask if the injury is due a direct blow or if it is due to a twisting force. Other questions addressing the symptoms will be asked.

Different diagnostic imaging tests may be done to in order to accurately diagnosis you. Such imaging tests may include:

An X-ray scan. A diagnostic test which makes use of electromagnetic beams to create images of internal tissues, bones and organs on to a screen. It can be used to check for fractures.
Magnetic resonance imaging, MRI scan. Uses electromagnet and computer technology to produce images of the inside of the body. It can be used check for torn ligaments.
Computerized tomography, CT scan. Uses a combination of special X-ray instrument and sophisticated computer technology to produce cross-sectional images, both horizontally and vertically, of the body. CT scans provide more-detailed images than general X-rays.

WHAT ARE THE TREATMENT OPTIONS AVAILABLE?

The treatment of headaches depends on the kind of headaches experienced. As mentioned earlier, most headaches are tension headaches, and they usually resolve within a few hours, with rest and some over the counter pain killers. The same thing applies to exertion headaches. However, other kinds of headaches, like migraines and cluster headaches, require special medications.

What treatment options are available?

The type of treatment given to a person with knee ligament injury depends on the severity of it. Mild and moderate sprains can generally be treated using home remedies, but severe sprains always require professional assistance. The following home remedies can be used in treating mild and moderate sprains:

Resting and elevating your knee
Applying ice
Compressing your knee using an elastic bandage
Using a knee brace to provide stability and support
Taking anti-inflammatory pain relief medications like acetaminophen or ibuprofen to help with the pain

Seeking further treatments from a physiotherapist in addition to the home remedies will go a long way in ensuring that the ligament fibers heal the right way, consequently bringing down the risk of a future occurrence.

Severe sprains, most times, require surgery for correction, particularly if the ACL or PCL is involved, or if more than one ligaments are torn. The type of surgery that will be carried out is called reconstructive knee surgery, where tendons from other parts of your leg or from a cadaver are removed, and used to replace the torn ligament. A reconstructive knee surgery for an APL or PCL injury is complicated. Not everyone is a good fit for the procedure. If the instability in the knee can be managed, the doctor may advise against a reconstructive knee surgery.

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