What should I do if the patellar ligament is injured?

Written by Na Hong Wei
Orthopedics
Updated on September 26, 2024
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Once a patellar ligament injury occurs, the first step is to immobilize the area; stop all activities to prevent further damage and secondary injuries. Secondly, apply ice. The initial ice application should last from half an hour to an hour, applied directly to the injured patellar ligament. Thirdly, bandage to immobilize the area, primarily using an elastic bandage and cotton padding to compress the knee joint. This can help stop bleeding and limit swelling. Fourth, elevate the injured limb to at least 30 degrees above the level of the heart. After these measures, it's necessary to go to the hospital for further examination including physical assessments by a doctor, X-rays, or an MRI to fully understand the extent of the ligament damage. If there is a partial tear of the ligament without complete discontinuity, conservative treatment such as casting or bracing can be effective, typically for three to four weeks. However, if the ligament is completely torn and surgery is clearly indicated, surgical treatment should be followed by the use of a brace for six weeks. Thus, proper early management of a patellar ligament injury is crucial, followed by hospital evaluation. Additionally, since patellar ligament injuries often coincide with fractures or damage to other structures such as the meniscus or cruciate ligaments, these factors cannot be overlooked.

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Symptoms of knee ligament injury

The ligaments in the knee joint are quite complex, often resulting from trauma, strain injuries, or lateral impacts. Symptoms such as reluctance to move the knee, pain, and worsened pain after movement usually necessitate a hospital examination. Lateral stress tests examine the medial and lateral collateral ligaments, drawer tests check the anterior and posterior cruciate ligaments, and pivot shift tests or squat walking tests assess the meniscus. If necessary, an MRI is performed for diagnosis. Early detection and treatment are crucial. If trauma is frequent, or instability after injury occurs, one should seek hospital examination. Ligament damage often heals slowly, typically taking around a month to fully recover.

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Post-symptoms of knee ligament injury

The knee joint has four crucial ligaments: the anterior and posterior cruciate ligaments, and the medial and lateral collateral ligaments. They act like four pillars, firmly anchoring the knee joint in a very stable and normal position. If any of these ligaments rupture, this balance is disrupted, causing the knee to move abnormally in a certain direction, leading to increased local wear and tear or compensatory wear in other parts. Therefore, if ligament damage is not repaired, and the balance is disrupted, it can lead to many complications or sequelae. The first is traumatic arthritis. The second is patellar chondromalacia. The third is meniscus damage. The fourth is damage to other ligaments, or even rupture. The fifth is knee arthritis, also known as OA, or degenerative changes. The sixth is knee effusion and synovitis. Thus, the sequelae of knee ligament injuries are numerous and troublesome.

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Is it necessary to get an MRI for a ligament injury?

After ligament injuries, the common imaging examinations usually include standard X-rays, CT scans, and MRI. X-rays are mainly used to observe the overall shape of the bones and the alignment, CT scans are primarily for examining the condition of the bones at the injury site, especially the form of the bones, while MRI mainly uses the hydrogen atom content, or water content, to determine if there is an injury. When a ligament is injured, there won't be bleeding, which leads to an increase in water content; thus, an MRI can easily reveal the increased water content and help diagnose the injury. Therefore, the best method to diagnose ligament injuries is through MRI. Of course, X-rays are used for general overview and alignment, which are the most basic and common examinations, followed by CT scans. Generally, CT scans are not necessary unless there is a special circumstance.

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Can a ligament injury cause the knee to make noise?

Whether the knee will make noise after ligament damage depends on the condition of the ligament damage. If it is an anterior cruciate ligament injury, generally the knee will not make noise. However, if the anterior cruciate ligament injury is combined with damage to the meniscus or cartilage, forming loose bodies, popping noises in the knee joint can occur. If there is damage to the medial or lateral collateral ligaments of the knee joint, which causes instability in the knee joint, this can also lead to popping sounds. If instability of the patella is caused by damage to the patellar ligament of the knee joint, changes in the alignment of the patellar joint during movement can also cause popping noises in the knee joint.

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What should I do if I have a knee ligament injury?

Ligament injuries in the knee are commonly seen in two areas: the first is the anterior cruciate ligament (ACL) injury, and the second is the medial collateral ligament (MCL) injury. The treatment for these two ligament injuries is the same; for instance, in cases of just a simple ligament tear or partial tear, it only requires the use of a plaster cast for external fixation, and immobilization for three to four weeks can achieve recovery. If there is a complete tear, surgery might be needed. There are two types of surgeries: the first one involves direct repair of the ligament, the second involves using autologous tendons to reconstruct the ligament, restoring the stability of the entire knee joint. To determine whether you have a tear, complete tear, or partial tear, it is necessary to undergo an MRI of the knee to confirm.