Orthopedics-Online

External ligament tear on the knee

Synonyms

Injury to the lateral collateral ligament
External ligament rupture

see also: Inner ligament injury, External meniscus tear

English: rupture / injury of collateral ligament

introduction

In the case of lateral ligament injuries, it is usually a tear of the same. Usually the tear is complete - there are hardly any incomplete tape tears.

Definition of outer band

The outer ligament of the knee joint runs on the outside of the knee joint from the thigh bone to the fibula.

It is not fused with the joint capsule of the knee joint and is also narrower than the inner ligament of the same joint.
The outer ligament is taut when the knee joint is extended and rotated outwards.
When the knee is extended, it serves together with the inner ligament for stabilization; when the knee is flexed, the two ligaments limit the external rotation.

Read more on the topic: Outer ligament of the knee joint

Summary

The Outer ligament of the knee joint belongs to the so-called side ligaments and runs - as the name suggests - on the outside of the knee joint. It serves the lateral stabilization. If it is torn, the main result is pain and instability.
The root cause is mostly a trauma (Rotation, contortion). The doctor (usually Orthopedists and / or sports medicine specialists) has a simple manual option to test the stability of the knee joint by checking whether it can be opened. However, more precise statements can only be made using the MRI scan of the knee to be hit.
The therapy depends on the extent of the injury (outer ligament tear), and can range from immobilization for a few days to surgery. The prognosis is usually good.

Appointment with a knee specialist?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The knee joint is one of the joints with the greatest stress.

Therefore, the treatment of the knee joint (e.g. meniscus tear, cartilage damage, cruciate ligament damage, runner's knee, etc.) requires a lot of experience.
I treat a wide variety of knee diseases in a conservative way.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

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60311 Frankfurt am Main

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Further information about myself can be found at Dr. Nicolas Gumpert

causes

The outer ligament usually only tears as a result of trauma (medical term for accident). This can be a kinking, a rotational trauma or a knee joint dislocation, such as those that occur when skiing or playing soccer.

Also read: Twisted knees - you have to pay attention to this

Symptoms

General symptoms of a torn ligament include Pain and a certain instability of the knee joint.

Other symptoms are:

Painful restriction of movement
Pressure pain on the tape
Possibly. Joint effusion, including bruise in the joint
Feeling of instability

Characteristic pain associated with a ruptured ligament

If there is a tear in the outer ligament of the knee joint, this is immediately evident violent pain connected.
In addition, there is usually pressure pain on the torn outer ligament and the knee joint is no longer resilient due to pain, swelling and lateral instability.

In order to reduce pain when tearing the outer ligament of the knee joint as quickly as possible, immediate action should be taken after the so-called PECH scheme be proceeded.
The P stands for Break and means that any physical activity should be stopped for the time being and the affected leg should be rested.
The E. stands for ice, the injured knee joint should be immediately cooled with an ice pack, ice gel or ice spray. This can significantly reduce the swelling and pain.
The C. stands for compression (English: compression) and means that a pressure bandage or the like is also applied to further reduce the swelling.
The H stands for Elevation. The injured leg should be raised to promote venous return and to reduce the swelling of the knee joint.

In addition, pain relievers such as Ibuprofen, be applied.
If this scheme is not followed and the knee joint injury is ignored, the injury can become chronic and knee joint pain and instability may persist.

Diagnosis of an external ligament tear

In general, it can be said that the examination of the injured knee can be difficult due to pain. An outer ligament tear must also be of a Outer ligament stretch be delimited.

The lateral stability test is used to examine the integrity of the side ligaments. The knee joint becomes full Elongation but also in 20 degrees of flexion tries to "open" to the side. If the inner side ligament is torn, it can be opened outwards and vice versa. Is this Outer band injured, i.e. torn, the knee joint can be "opened" from the outside. The examiner presses against the lower leg from the outside with the thigh fixed. You can feel that the Joint space opens easily.

For a more precise diagnosis, MRI images are made in the case of a ruptured ligament in the knee joint. roentgen allows only an assessment of the bony involvement, but cannot directly prove the ligament injury. Theoretically, a knee mirror, the so-called Arthroscopy, possible, but which the MRI scan of the knee has given way. In addition, it is more likely to be used for cruciate ligament tears, as arthroscopic surgery is also possible here.
Through a Knee MRI other diagnoses, such as a meniscus tear, Cruciate ligament tear etc. are shown. In the meantime, it is almost always a case of major injuries MRI of the knee necessary.

MRI of the knee joint

To diagnose an external ligament tear in the knee joint, a MRI scan of the knee joint become necessary.

During an MRI scan (Magnetic resonance imaging) is a non-invasive imaging procedure. This means that no instruments need to be inserted into the body during this examination.
With the help of a strong magnetic field, organs, tissues and joints can be displayed in the form of sectional images during an MRI examination and finally assessed for pathological changes.
The MRT examination is characterized by a good soft tissue contrast and high resolution and is therefore very well suited to depicting ligament structures and cartilage parts of the knee joint, among other things.

With the help of an MRI examination, injuries to the knee joint, such as torn ligaments, can also be diagnosed. The involvement of other ligament structures or cartilage parts of the knee joint, such as the meniscus or the cruciate ligament, can also be detected in the MRI.
In the case of outer ligament tears with additional damage to bone parts, an X-ray examination may be necessary in addition to the MRI examination, since bony structures can be better demarcated here.

According to current studies, the MRI examination is an examination procedure without side effects, which, in contrast to the X-ray examination, does not require any harmful X-rays. The MRT examination is therefore used nowadays for a large number of injuries to the musculoskeletal system.

Illustration of an outer ligament tear

Outer ligament tear: right knee joint from the front (A)

Outer band
(= outer sideband
of the knee joint) -
Ligamentum collaterale fibulare
Joint capsule -
Articular capsule
Femur - Femur
Kneecap - patella
Inner band
(= inner sideband
of the knee joint) -
Ligamentum collaterale tibiale
Inner meniscus -
Meniscus medialis
Anterior cruciate ligament -
Ligamentum cruciatum anterius
Outer meniscus -
Lateral meniscus
Shin - Tibia
Fibula - Fibula

You can find an overview of all Dr-Gumpert images at: medical illustrations

therapy

The Therapy of the lateral ligament tear depends on the extent of the injury. If the ligament is simply strained or overstretched, a short-term immobilization is sufficient (some days) of the joint, followed by Muscle building training.
In the event of a rupture (med. Term for a tear) of the outer ligament, it depends on whether this injury has complex side effects. If there is no bony involvement (is the Thigh - as well as the Lower leg bones unharmed in its structure) and instability of the knee joint is absent, conservative treatment in the form of a splint takes place for about 6 weeks.
Complex ligament ruptures (Torn ligament) with bony involvement and / or instability of the knee joint must be treated surgically. The torn band is reattached by means of a seam. If parts of the bone are torn out, they are fixed with screws.

OP of an external ligament tear

Depending on the extent of the injury, conservative procedures such as wearing a splint and regular muscle building training and surgical procedures can be considered in the event of a torn knee ligament.

Surgical procedures are very rarely used for torn ligaments.
Only complicated tears of the outer ligament, in which bone parts are additionally injured, or which are clearly marked Instability in the knee joint go along are treated surgically.
In addition to the extent of the injury, the age of the person affected and other underlying diseases play a major role in the decision whether the lateral ligament tear is treated conservatively or surgically.

During the operation, either the torn parts of the ligament are sewn back together or the torn parts of the ligament are completely removed and replaced with another healthy tendon, for example the Kneecap tendon (Patellar tendon) replaced.
The procedure is usually done minimally invasive as a joint reflection (Arthroscopy of the knee joint) and the duration of the procedure is up to two hours, depending on the extent of the injury.

As a rule, surgical interventions on the outer ligament in general anesthetic or in Spinal anesthesia carried out. Operations on the outer ligament are in principle low-risk interventions, but complications such as Knee Joint Infections, Knee joint bleeding or Cartilage damage occurrence.
After the operation, the leg should first be protected, cooled and raised. Physiotherapy with muscle building training should also be carried out as soon as possible.

prophylaxis

Regarding the prophylaxis of collateral ligament ruptures in general, it should be said that only the sports that cause it (Skiing, playing football) should be exercised with caution. Strong thigh and lower leg muscles also counteract the ligament injury, as they do this Knee joint stabilize.

forecast

In violation of the Sidebands (Outer ligament tear / inner ligament tear) there is usually a good chance of unrestricted usability of the joint after a corresponding recovery phase.
How long this lasts depends on the type and severity of the previous injury. The worse the injury was (just stretching vs complex crack with bone involvement) the longer the complete rehabilitation will of course take.

Duration of an external ligament tear in the knee

The healing process of a torn outer ligament of the knee joint takes several weeks, depending on the extent of the injury.
Immediate action after PECH scheme (Break, ice, elevation, compression) can reduce consequential damage and shorten the duration of the healing process.

As a rule, the injured leg should first be supported for at least six weeks using forearm supports or a splint (so-called orthosis) be immobilized. At the same time should be done as soon as possible with regular physical therapy started and muscle building exercises are carried out to regain the stability of the injured knee joint. Afterwards, in consultation with the attending physician, the knee can gradually be loaded more heavily.

The time until the injured knee can be fully loaded again can be up to a year.

How long should you do without exercise?

If the outer ligament tears in the knee joint during exercise, further strain on the knee joint should be avoided and a break in sport should be taken.
The injured leg should first after PECH scheme (Break-Ice-Elevation-Compression) be treated.
The leg should then be immobilized for at least six weeks using forearm supports or a splint.

Gradually, the injured leg can be subjected to heavier loads. This should only be done in consultation with the attending physician and under regular physiotherapeutic supervision.
Through targeted muscle building in the context of physiotherapy, the stability of the injured knee joint can be rebuilt and full sports fitness can be achieved. After a torn outer ligament of the knee joint, depending on the severity of the injury, a sports break of up to a year may be necessary. If physical activity is not paused, the injury can become chronic and instability and pain in the knee joint persist.

Appointment with a knee specialist?

I would be happy to advise you!

The knee joint is one of the joints with the greatest stress.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in: