The knee's ligaments can be damaged following traumatic blows to the joint resulting from sports, accidents, or falling improperly. Depending on the injury's extent, treatments for knee ligament injuries can range from conservative treatment to surgery.
Grade 1 injuries that present minimum damage and symptoms are most commonly treated using a non-surgical conservative approach that includes:
- RICE – resting, icing, compressing, and elevating the knee to improve healing.
- Bracing the knee to stabilize it and prevent other injuries.
- Non-Steroidal Anti-Inflammation Drugs (NSAIDs) to reduce swelling and pain.
- Physical therapy to accelerate recovery, including strength and stretching routines.
LCL and MCL ligament injuries and tears are the most responsive to this initial round of treatment. However, when damage to any ligament impairs the knee's ability to function correctly, physicians may recommend surgery.
Knee ligament repair aims to restore minimally-damaged tissue and reattach it to the bone. Knee ligament reconstruction replaces damaged ligaments using either the patient's own tissue (autograft) or donor tissue (allograft). Regardless of the procedure, surgery is performed with the patients under a general, regional or local anesthetic.
- Arthroscopic surgery is a minimally-invasive procedure with small incisions around the knee to allow access to a thin camera (arthroscope) and specialized small instruments to perform ligament repairs and reconstructions. This method is favored by surgeons for its good outcomes and faster recovery rate and is especially recommended for ACL reconstructions.
- Open surgery is a more intrusive approach. A wider incision is made to allow operating physicians a clear and unobstructed view of the damaged ligaments and perform the necessary repairs or reconstructions. This method may be required for MCL and LCL surgeries due to their positioning and multiple extensive ligament injuries.
- Multi-ligament surgery may be required if more than one of the knee's ligaments has suffered damage or if previous unnoticed injuries surface concomitantly. Arthroscopic and open methods are used as needed, although surgeons will prioritize ligament repair for recently damaged structures, followed by surgical reconstructions with grafts.
Most knee ligament surgeries take 1-2 hours to complete and have overall good outcomes. Arthroscopic surgery is an outpatient procedure, allowing individuals to return home on the same day as their operation. Open and multi-ligament surgery may require a few days of clinical care before patients can return home and begin focusing on their recovery.