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Injuries To The Knee • Ligament s • Tendons • Menisci • Patella • Bursa Anterior Cruciate Ligament Definition An anterior cruciate ligament (ACL) injury is a tear in the ACL ligament. The ACL is located in the middle of the knee joint and connects the lower leg bone to the thigh bone and prevents the leg bone from sliding too far forward at the knee, which would cause instability. Causes Most ACL tears occur during non-contact injuries, such as: Planting the foot and cutting Pivoting Landing on a straight leg Making a sudden stop Posterior Cruciate Ligament • Definition The PCL is the primary stabilizer of the knee and the main controller of how far backward the tibia moves under the femur. Causes • The most common way for the PCL alone to be injured is from a direct blow to the front of the knee while the knee is bent. Since the PCL controls how far backward the tibia moves in relation to the femur, if the tibia moves too far, the PCL can rupture. Medial Collateral Ligament The medial collateral ligament spans the distance from the end of the femur (thigh bone) to the top of the tibia (shin bone) and is on the inside of the knee joint. The medial collateral ligament resists widening of the inside of the joint, or prevents “opening-up” of the knee. Causes Because the medial collateral ligament resists widening of the inside of the knee joint, the MCL is usually injured when the outside of the knee joint is struck. Severity of an MCL Injury Grade I MCL Tear Most athletes miss 1-2 weeks of play. This is an incomplete tear of the MCL. The tendon is still in continuity, and the symptoms are usually minimal. Patients usually complain of pain with pressure on the MCL, and may be able to return to their sport very quickly. Grade II MCL Tear 3-4 weeks of rest is necessary. Grade II injuries are also considered incomplete tears of the MCL. These patients may complain of instability when attempting to cut or pivot. The pain and swelling is more significant. Grade III MCL Tear Healing may take 6 weeks or longer. A grade III injury is a complete tear of the MCL. Patients have significant pain and swelling, and often have difficulty bending the knee. Instability, or giving out, is a common finding with grade III MCL tears. A knee brace or a knee immobilizer is usually needed for comfort. Lateral Collateral Ligament The lateral collateral ligament is located on the outer side of the knee. It attaches the thighbone (femur) to the outside bone in the lower leg (fibula). Causes The lateral collateral ligament can be injured by a twisting motion or from a blow to the inner side of the knee. Symptoms may include the following: pain on the outer side of the knee, swelling, heat, tenderness, feeling of the knee "giving way" and one can hear or feel a pop or snap at the time of injury. Tendon Injuries The patellar tendon (or ligament as it is sometimes called) connects the patella (kneecap) to tibia (shin) bone. This is the tendinous region just below the knee cap. Causes Under repeated stress with certain sports, an overuse of the patella tendon can occur. This can often lead to inflammation and even a partial tearing of the tendon. Injury to this area often affects athletes involved in jumping or throwing sports. Patellar Tendinitis Inflammation mainly of the patellar tendon, but which may also involve the quadriceps tendon. Jumper's knee is thought to be due to tiny lesions in the tendon that develop as a result of constant, repetitive jumping. Ruptured Patella Tendon Quadricep Tendon Injuries Quadriceps Tendonitis, It is a condition that is painful and the degeneration of the inside of the quadriceps tendon. Some of the time other conditions might be connected with quadriceps tendonitis. Diabetes, gout, parahypothyroidism are other conditions that might be affected with quadriceps tendonitis. Meniscal Injuries Meniscal injuries damage the cushioning tissue between the tibia and the femur, inside the knee joint, on both sides (medial and lateral) of the knee. Causes They are highly vulnerable to injury from abrupt rotations of the knee while it is bearing weight, for example, when you turn to hit a tennis ball, rotating your thigh (femur) while leaving your foot stationary. Types of Meniscal Tears MRI Torn Medial Meniscus Arthroscopic Repair OUCH!!!!!!!!! Patella Injuries (Chondromalacia) • Most patients will complain of pain on the front of the knee that is exacerbated by stair climbing, squatting maneuvers, kneeling, and prolonged sitting. • Muscle atrophy leads to imbalance in the muscles that control movement of the patella within its groove on the end of the femur. Patella Injuries (Chondromalacia) Patella Injuries (Bursitis) Prepatellar bursitis is the inflammation of a small sac of fluid located in front of the kneecap. This inflammation can cause many problems in the knee. Causes Bursitis is the inflammation of a bursa. The prepatellar bursa can become irritated and inflamed in a number of ways. A direct blow or a fall onto the knee can damage the bursa. Q Angle