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What is cruciate ligament?
In the knee there is an anterior cruciate ligament and a posterior cruciate ligament. Medically, these are called the Anterior Cruciate Ligament – ACL (anterior cruciate ligament) and the Posterior Cruciate Ligament – PCL (posterior cruciate ligament). Its function in the knee is to stabilize forward and backward sliding, respectively. 90% of all cruciate ligament injuries affect the anterior cruciate ligament. One of the reasons why the posterior cruciate ligament is injured so much less often is that this ligament is clearly thicker than the anterior. In connection with a cruciate ligament injury, the meniscus and cartilage in the knee can also be damaged.
Why is the cruciate ligament damaged?
An anterior cruciate ligament injury is primarily a sports-related injury. In sports where contact with other players occurs, anterior cruciate ligament injuries are more common.
The most common cause of an anterior cruciate ligament injury is running, stopping suddenly and quickly changing direction with a slightly bent knee. A type of movement that is often found in, for example, football, handball, floorball. The risk is further increased by good grip in the sole or studs that fix the foot to the surface.
Women are affected more often than men. Why, is a bit unclear. Reasons that are discussed are that women's cruciate ligaments are thinner than men's. Women often have more mobile knees than men. Some studies point to hormonal factors, where one seems to be able to see an increased risk of cruciate ligament damage before menstruation.
An injury to the posterior cruciate ligament often occurs in connection with trauma to the knee where the lower leg is forcibly pushed backwards in relation to the thigh or the knee is overextended during heavy load. Here, relatively great force is required at the time of the accident for the posterior cruciate ligament to be damaged or torn. For example, in a car accident where you hit your knee on the dashboard or if you are hit from the front in ice hockey and hit on the lower leg with your knee bent.
Symptoms of cruciate ligament injury
Anterior cruciate ligament injury: Usually marked pain in the knee at the time of injury. A relatively rapidly increasing swelling in the knee, with difficulty extending the knee as a result. It is not uncommon for the knee to feel unstable when loaded.
Posterior cruciate ligament injury: Usually slightly more diffuse symptoms than in anterior cruciate ligament injury. Swelling often less pronounced. Also stiffness and pain in the knee. The pain is not rarely localized to the back of the knee. Feeling of instability in the knee is not so common in posterior cruciate ligament injuries. korsbandsskada. Svullnad ofta mindre uttalad. Likaså stelhet och smärta i knät. Smärtan inte sällan lokaliserad till baksida knä. Instabilitetskänsla i knät inte så vanlig vid bakre korsbandsskada.
Treatment of cruciate ligament injury?
Immediately at the time of injury, it is a good idea to apply compression with a sturdy elastic bandage around the knee for about 30 minutes, with the knee above heart level. Then continue to apply slightly lighter pressure around the knee for the next 24 hours. During that 24 hours, it is recommended to rest and relieve the knee. Then gradually increase the load. It is important to slowly start moving the knee without provoking further pain and swelling. If you cannot walk without a limp, one or two crutches are recommended to relieve the knee when walking.
Our physiotherapists have the expertise to test and examine the knee. If a cruciate ligament injury is suspected, we refer the patient to an orthopedist. The patient often undergoes an MRI scan and a decision is made on whether surgery should be performed. Normally, the patient returns to us for rehabilitation training of the knee. If you have a basically stable knee, you can do well without surgery. What is crucial is whether the knee bends back and forth or if you are going to return to sports that include stops, starts and twisting of the knee, then surgery is usually performed.
The rehabilitation time after surgery for an anterior or posterior cruciate ligament injury varies, depending on whether the injury also involved the meniscus and/or collateral ligament. Under optimal conditions, you can expect at least 6 months before you are back to your pre-injury activity level. When testing, we want you to have 100% of the strength and function in the operated leg, compared to the uninjured leg. This is what determines when a full return to demanding activity is recommended by us.
Rehabilitation is, as always with us at Alta Vita Physiotherapy, individualized. The goals are set based on the desired level of activity after rehabilitation. The goal is to optimize mobility, coordination and load tolerance in the knee. We create a treatment plan, support and help the patient in the progression and development of rehabilitation.
What is the prognosis for cruciate ligament injuries?
Of people who have been involved in high-level sports and have undergone surgery to replace a cruciate ligament, between 60-90% return to sports at the same level as before the injury. 2 years after surgery, 75-95% of patients are satisfied with the results.
If you have suffered a cruciate ligament injury, the risk of developing wear and tear on the cartilage in your knee, osteoarthritis, increases in the future. Whether surgery is performed or not does not seem to affect the risk of osteoarthritis.
