How dangerous is an inner band rupture?

A torn inner ligament of the knee can usually be treated well and has a good prognosis. In most cases, conservative treatment in the form of immobilization and physiotherapy is sufficient to build up muscles. Surgery is usually only necessary for more complex injuries when other structures in the knee are involved.

This must be assessed both when the knee is stretched and when it is bent at 30°. If the inner ligament is injured, i.e. torn, the knee joint can be “unfolded” from the inside. The examiner presses laterally against the lower leg from the inside with the thigh fixed.

You can feel that the joint gap opens slightly. For a more precise diagnosis, MRI images are taken in the case of ruptures of the outer ligament of the knee joint. X-rays only allow an assessment of the bony involvement, but cannot directly detect the ligament injury.

Theoretically, a knee endoscopy, the so-called arthroscopy of the knee, is also possible, but this has given way to the MRI examination of the knee. In addition, it is more likely to be used in the case of cruciate ligament ruptures, as arthroscopic surgery is also possible in this case. Therapy for torn ligaments depends on the extent of the injury.

If the ligament is only stretched or overstretched, short-term immobilization (a few days) of the joint is sufficient, followed by muscle building training. In the case of a rupture of the inner ligament, it depends on whether the injury has complex side effects. If there are no bony involvement (i.e. if the structure of the thigh and the lower leg bone is uninjured) and the knee joint is unstable, conservative treatment in the form of a splint for about 6 weeks is also necessary.

Complex ligament ruptures with bony involvement and/or instability of the knee joint must be treated surgically. The torn ligament is refixed with a suture.If parts of the bone are torn out, they are fixed with screws. Depending on the extent of the torn inner ligament, it may be necessary to stabilize it with a splint first.

These splint systems restrict the range of motion of the joint from the outside and thus prevent excessive stress. At the same time they have an important supporting function. The possible mobility can be adjusted in such a way that it allows movement appropriate to the respective healing state.

The main purpose of the splint is to prevent excessive flexion. However, the knee should not be fully stretched in the initial phase. Only about 60° should be allowed for flexion in the initial phase.

After a few weeks, the splint is adjusted to allow a flexion of 90°. However, what this adjustment of the flexion dimensions indicates, there are also a number of other concepts, some of which provide for considerably larger or smaller angles. In most cases these splints have to be worn for about 6 weeks.

During this time, physiotherapeutic exercises are still performed. Afterwards, the splint can be removed and the knee can now be trained without the additional safety device. The taping should on the one hand lead to a relief of the knee joint and on the other hand relieve the muscles that otherwise stabilize the joint.

In this respect, an application in case of a rupture of the inner ligament of the knee is possible in principle. However, the tape can never be used as a substitute for correct splinting in the initial phase. Neither can taping replace the often lengthy and strenuous training.

However, if instability in the knee joint continues to occur after the actual therapy is completed, taping can provide short-term relief. In this case, bandages are probably the simpler solution. In general, however, one should bear in mind that any external support for the muscles means that they have to perform less and are therefore more likely to weaken in the long term.

In this respect, a tape or bandage can intensify the actual problem. In contrast to a tear in the outer ligament, a tear in the inner ligament usually heals very well under conservative therapy. Surgery is only necessary in the case of very pronounced tears or severe instability after completion of conservative therapy.

Surgery is also performed if other parts of the knee, such as the meniscus or cruciate ligament, are affected. Even in the case of a complete tear of the inner ligament, splinting can usually achieve similarly good results as surgery, which is why conservative treatment seems to be recommended here as well. Especially since a long rehabilitation and training phase follows the operation. However, if the knee joint is still not stable after completion of the physiotherapeutic and conservative treatment, the use of a ligament replacement may be necessary.