Knee Injury Treatment

Knee Ligament Injury

Knee injuries are common in sports and vary in severity. The knee has four key ligaments: medial and lateral collateral ligaments, and anterior and posterior cruciate ligaments, as well as menisci, which act as weight-bearing cartilage. Teens are more likely to break a growth plate, while adults tend to tear ligaments under similar stress.

Ligament injuries are classified into three grades:  

• Grade 1: Minor fiber damage, no loss of stability, minimal swelling, heals in 3-6 weeks with bracing. 
• Grade 2: Partial fiber tearing, swelling, and slight instability; painful during stress tests. 
• Grade 3: Complete tear, significant instability, less pain after initial injury, often linked to ACL and meniscus damage ("terrible triad").  

Treatment depends on age, activity level, and injury severity.

Treatment of Sprains:

Ligament injuries in the knee are classified into three grades based on severity, with treatments ranging from simple home care to surgical intervention. Here's an overview to help understand the appropriate treatment for each type of sprain or tear:

Grade 1: Mild sprain

Treatment includes an Ace wrap, ice, and anti-inflammatory medication like ibuprofen or meloxicam. Walking is fine, but avoid running or jumping for about 3 weeks. Gentle cycling and straight-leg raises (quad sets) can help maintain muscle strength.

Grade 2: Moderate injury

A hinged knee brace or immobilizer is recommended to prevent muscle wasting. Straight-leg raises (quad sets) should be done several times daily without added weights. Recovery focuses on stability and muscle preservation.

Grade 3: Severe ligament tear

It's critical to identify whether it's an isolated ligament injury or involves the meniscus and ACL.  

Isolated MCL tears are usually non-surgically treated with a hinged knee brace for 6–12 weeks. Full weight-bearing is possible if comfortable, though a cane is often needed initially.

Anti-inflammatory meds and quad sets are key during recovery.

If the meniscus is torn, arthroscopy may be required to repair it. Combine ACL reconstruction with meniscus repair to reduce the risk of re-tearing. Note: ACL tears typically need reconstruction using a tendon graft.

Early diagnosis and tailored treatment are crucial for optimal recovery.

Anterior Cruciate Ligament Injury (ACL)

ACL injuries are common and often result in severe swelling, pain, and instability. These injuries typically involve a complete (grade 3) ligament tear and may also damage the meniscus in about 50% of cases. Early diagnosis is crucial, with physical exams like the Lachman test or pivot shift test providing the most accurate results shortly after the injury. For delayed cases, an MRI may be needed to assess the ligament and menisci.

At Nebraska Hand & Shoulder Institute, P.C., we specialize in ACL injury evaluation and treatment. While not everyone requires ACL reconstruction, it is often recommended for active individuals, particularly teenagers or athletes, to restore stability and prevent long-term knee damage. Our team considers factors like activity level, lifestyle, and injury severity to create personalized treatment plans. Options range from non-surgical management with rest, ice, and physical therapy to advanced surgical reconstruction for those needing full-function restoration.

Whether you’re a competitive athlete or looking to maintain mobility in daily life, Nebraska Hand & Shoulder Institute, P.C. is here to guide your recovery.

The Posterior Cruciate Ligament (PCL)

The posterior cruciate ligament, or PCL, is injured much less frequently than the anterior cruciate ligament. It is difficult to diagnose except on an MRI scan. Physical exam is frequently similar to that for the anterior cruciate ligament. The symptoms may be vague and the outcome of treatments in the form of reconstruction is less predictable than for the anterior cruciate ligament. Generally, the anterior cruciate ligament and the posterior cruciate ligament are not damaged simultaneously except in a knee dislocation wherein all 4 of the main ligaments are torn. Fortunately, knee dislocation is a very rare injury. A high percentage of these cases are complicated by damage to the popliteal artery, bringing up the risk of loss of one’s leg unless a diagnosis is made promptly.

Collateral Ligament

Most people don’t have long-term symptoms from medial collateral ligament injury, even if it is a grade 3. There might be some minor feelings of soreness at times and some increased laxity but it doesn’t typically result in any long-term problem. Full recovery takes about 6 weeks for a grade 1 injury, perhaps 3-6 months in a grade 3 injury, with grade 2 somewhere in between. The diagnosis is made on the basis of a physical exam and x-rays ruling out a broken bone.

Anterior and Posterior Cruciate Ligaments

Severe swelling within an hour often signals this injury. Ice and an Ace wrap can help manage it, but the pain is significant. Draining blood from the knee after the first day can provide relief. Over the next week, restoring motion is the priority. If instability occurs, especially during athletic activities, surgery may be necessary, especially for a torn meniscus.

ACL reconstruction is best done using the patient’s own tissue, such as the patellar, quadriceps, or hamstring tendons. Cadaver grafts (allografts) are another option; though they carry a very low risk of rejection or disease transmission, are less painful, and may shorten surgery time, using one’s own tissue generally provides better long-term outcomes.

The reconstructed tendon initially starts stronger but weakens for about a year as it heals. Full strength takes approximately 12 months to return. For the first 6 months, avoid jumping or pivoting, though light running on flat surfaces may begin after 6 weeks. Rushing recovery, as seen with some professional athletes, increases the risk of re-injury and is not medically advised.

Take the Next Step in Your Recovery

Your knee health is key to staying active and enjoying life. At Nebraska Hand & Shoulder Institute P.C., we provide expert care for everything from knee pain treatment to knee surgery. Whether you’re seeking a knee pain specialist, orthopaedic doctor for knee pain, or looking for effective knee pain relief, we’re here to guide you. If you’ve experienced a knee injury, trust our doctor for knee injury care and recovery. Take the first step toward personalized treatment and lasting relief today!