The document discusses the most common knee injuries, focusing on the anterior cruciate ligament (ACL) and its role in knee stability, as well as other injuries related to ligaments, meniscus, patella, and cartilage. It highlights the prevalence of ACL injuries in sports, especially among female athletes, and the signs of a serious knee injury that requires immediate medical attention. The document also provides information on treatment options, both nonsurgical and surgical, for managing knee injuries.

1. Most Common Knee Injuries
& Their Treatments

2. Introduction
The human knee is the largest joint in the body. It is composed of
the Tibia, Femur and Patella bones; the joint surfaces of which are
covered in cartilage which allows smooth movement and gliding of
the joint surfaces. There are multiple structures around the knee
which hold the bones in place and allow the movement to occur and
due to the significant forces generated, the knee is very prone to
injury.

3. The Structures At Risk Of Injury
• Ligaments – ACL / PCL / MCL / LCL
• Meniscus
• Patella
• Cartilage

4. Ligaments – ACL / PCL / MCL / LCL
ACL Injuries
ACL stands for anterior cruciate ligament. The anterior
cruciate ligament is one of a pair of cruciate ligaments in the
centre of the human knee. These two ligaments form part of a
complex ligamentous structure which provides stability to the
human knee. The ACL is a relatively short ligament with two
bundles and connects the top of the tibia to the end of the
femur within the knee joint. Its main function is to provide
stability to the knee mainly stopping the tibia from translating
too far anteriorly. The ACL provides around 85% of the
restraining force to this anterior tibial displacement. The ACL
is the most injured ligament of the four located in the knee.

5. Ligament Injuries (Non ACL)
Aside from the Anterior Cruciate Ligament (ACL),
there are a number of other ligaments in the knee
that can be injured including posterior cruciate
ligament (PCL), the medial collateral ligament
(MCL) and the lateral collateral ligament (LCL).

6. Meniscal Injury
The meniscus is a form of cartilage which is C-shaped and triangular in
cross section and sits in between the femur and the tibia on the medial
and lateral sides of the knee. There are two menisci in the knee which
differ slightly in their shape and biomechanics.
The main function is to protect the femur and tibial cartilage joint
surfaces from the incredible amount of force and load that passes
through the knee joint on a daily basis from walking to intense
exercise.
The meniscus is attached to the top of the tibia via the anterior and
posterior horns and through the capsular attachments circumferentially
around the knee. It is through the capsule that the meniscus receives a
little blood supply to its periphery. The outer one third of the
meniscus has blood flow going through it but the inner two thirds of the
meniscus is avascular and has no blood flow.

7. Patellofemoral Instability
The patellofemoral joint is a very complex joint
consisting of two bones at the front of the knee. The
two bones are the patella (kneecap) and the front of
the distal femur (thigh bone just deep to the kneecap.)
The patella joins with the front of the femur in the
area called the trochlea. This joint is made up of
complex interplay of muscles, tendons, ligaments and
boney anatomy. Problems with any of these can cause
pain and instability around the patellofemoral joint.

8. Cartilage Injury
This is a painful condition, where a small area of cartilage is damaged in an
otherwise healthy knee. If left untreated, this can cause the surrounding
cartilage to degrade and turn into full-blown Osteoarthritis.
Unfortunately, the cartilage can be damaged from trauma or other pathologies
like Osteochondritis Dissecans (OCD); this results in a painful lesion which if
left untreated can progress to early joint degeneration and osteoarthritis.

9. What Is The Most Common Knee Injury In Sports?
The Anterior Cruciate Ligament (ACL) rupture is the most
prevalent knee ligament injury, comprising 90% of all cases.
Around 15,000 ACL reconstruction surgeries are performed
annually in the UK, and approximately 400,000 in the USA. The
ACL, situated in the middle of the knee, stabilizes it
throughout its range of motion. Female athletes face a higher
risk, with a ratio of 4:1 compared to males, due to different
landing biomechanics and neuromuscular activation. Non-
contact pivoting injuries are the most common cause, often
occurring in sports like football, basketball, and skiing.
ACL injuries are frequently accompanied by damage to other
knee structures, such as the meniscus and ligaments, in 60-
70% of cases.

10. How Do I Know If My Knee Injury Is
Serious?
A significant "pop" sensation often accompanies an ACL rupture, followed by
rapid swelling within the knee joint due to bleeding. This immediate swelling
indicates a serious injury. In such cases, individuals may find it challenging to
bear weight on the affected knee and experience a noticeable decrease in knee
mobility, rendering movement difficult or impossible. These symptoms
underscore the severity of the knee injury and warrant prompt medical
attention.

11. Get The Best Treatment For Your Knee
Injuries At The Knee Clinic Manchester.
• In the immediate post injury phase, we would advise icing
the knee asap and attending a hospital or specialist clinic
like The Knee Clinic Manchester, for assessment.
• In the current climate, waiting times in Accident and
Emergency can be extremely frustrating. We are specialists
in assessing and managing these injuries and have the
highest quality team approach to get you moving and back on
your feet asap.
• The assessment involves an X-ray to exclude fracture and
then an MRI scan. A brace can be fitted to help support the
knee during the first 2-6 weeks and get it moving, and
start rehabilitation.

12. Nonsurgical Treatment
Numerous knee injuries respond well to straightforward treatments, including:
• Immobilization: Your physician might suggest a brace to stabilize your knee or a
cast to support bone healing. Crutches may also be provided to alleviate weight-
bearing on the injured leg, promoting protection.
• Physical therapy: Tailored exercises aid in knee function restoration and bolster
the surrounding leg muscles for enhanced support.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen
and naproxen effectively alleviate pain and swelling, facilitating the healing process.

13. Surgical Treatment
Many fractures and injuries around the knee require surgery to fully
restore function to your leg.
In some cases — such as for many ACL tears — surgery can be done
arthroscopically using miniature instruments and small incisions. Learn
more: Knee Arthroscopy
Fractures, on the other hand, often require open surgery with a larger
incision that provides your surgeon with a more direct view and easier
access to the injured structures.
SOURCE: Department of Research & Scientific Affairs, American Academy of
Orthopaedic Surgeons. Rosemont, IL: AAOS; February 2014. Based on data
from the National Ambulatory Medical Care Survey, 2010; Centers for
Disease Control and Prevention.
Get in touch for more details or if you want to discuss ACL
reconstruction surgery.