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Knee Injuries: What's Worse--A Single Ligament Tear or a Ligament Tear with Other Injuries?

Posted on: 11/30/1999
If you are a sports fan, you have probably heard of an athlete who has torn the anterior cruciate ligament (ACL). Maybe you've had the same injury.

The ACL is one of two ligaments that crisscross inside the knee to hold the two bones of the leg together. There are two common ways to tear or rupture the ACL. One is to keep the foot planted on the ground and twist the body over the leg. Another is getting tackled or hit from the side with a great force against the knee.

A knee injury can cause only the ACL to rupture, but often there are other injuries, too. It is not uncommon to tear the ACL and damage other knee ligaments or even tear the meniscus (knee cartilage). The torn ligaments are often repaired with an operation, but a torn meniscus can't always be repaired. Sometimes part or all of the meniscus has to be removed. However, without this pad of cartilage to protect the joint, the knee suffers extra wear and tear. This can lead to joint damage years later.

Doctors have tested the results of surgery to repair the ACL. Two groups of people were included in a study. One group of patients tore only their ACLs. The second group had patients with ACL tears plus other knee damage. The doctors used pain, swelling, and "give way" to guide their results. ("Give way" describes a sudden moment when the knee feels unsteady, like it's going to give out.)

There appeared to be no differences between these two groups five to 10 years after the operation. By looking at the joint, measuring joint motion, and using X-rays, doctors showed that both groups had good results.

Some members of the group with more damage ended up needing additional knee surgery, and they tended to have more reinjuries than the group with just ACL tears. Usually the repeated operations were needed because of problems with knee motion. This was most likely to happen during the time of early recovery and rehabilitation.

By continuing to look back at results of surgery, doctors can learn what works in the long term. This information can help guide future treatment methods.

References:
Timo Järvelä, MD, et al. Anterior Cruciate Ligament Reconstruction in Patients With or Without Accompanying Injuries. A Re-examination of Subjects 5 to 9 Years After Reconstruction. In Arthroscopy. October 2001. Vol. 17. No. 8. Pp. 818-825.

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