Lets talk Ligaments in Knees
The knee has a lot of ligaments (bone to bone attachments), to help stabilise and give greater range of motion.
I will talk about the Tibiofemoral joint of the knee. This joint is a modified hinge synovial joint, which means that it has a hinge movement (like a gate) but can also help rotate slightly and synovial means there is a fluid capsule.
This joint has some important ligaments that if you have watched any sports you may have heard the terms. Transverse ligament, medial and lateral minisci, anterior and posterior cruciate, medial and lateral collateral ligaments. Lets break them down.
Types of Ligament damage
The grades of ligament injury will reflect on how it is treated.
Grade 1 is when the ligament is stretched beyond its normal range, creating pain and inflammation.
Grade 2 this is where the fibres tear, depending on how many fibres tear will determine weather surgery is required.
Grade 3 is complete rupture and will require surgery.
The transverse ligament is a band-like ligament that sits inside the knee capsule. It attaches to the transversely in front of the margin of the medial and lateral menisci.
This ligament stops the front horns of the menisci from moving forward when extending the knee, it also prevents pressure being exerted on the menisci from the femur.
The Medial and Lateral Minisci are a fibrocartilage in the knee, they have a central body with front and back horns, thicker on the outside rim and thinner to the central edge. They are different size and have different attachments.
The Medial and lateral menisci help to transfer load and absorb shock. They help lubricate and give joint stability, they also provide nutrition to the articular cartlidge and help control movement of knee joint. They are one of the most commonly injured part of the knee structure damage can lead to osteoarthritis.
How are they damaged?
They are the most common injury in knees. Damage can occur for force between the femur (upper leg bone) and tibia (lower leg bone). Twisting while weight loaded flexed knee (think sports or labours).
Twisting injuries often include swelling, severe pain, can catch, clicking noise, unable to deep bend and knee locks in partial flexion. Pain is usually felt in the front, however medial or lateral would indicate tears on the sides. Weight bearing and turning increases pain can come on as a sharp pain for a moment with dull pain for a few hours. Pain can wake someone from sleep if the medial part of knee touches the other knee.
The Thessaly test is clinically the best test for meniscal tear. If Thessaly test is positive a MRI may be required.
How we can help
RICE- Rest, Ice, Compression bandaging and Elevation if acute. If chronic and non surgical than anti-inflammatories and Acupuncture.
Until next time keep moving