Tearing of the side bands | Torn ligament at the knee – treatment and important

Tearing of the side bands

The inner ligament, lat. ligamentum collaterale mediale, is one of the large stabilizing ligaments at the knee and runs inside the knee from the femur to the head of the tibia. The inner ligament protects the knee from excessive movement in the lateral plane, thus preventing the lower leg from bending outwards.

A torn ligament on the inner ligament therefore occurs when force is applied from the inside against the lower leg, but twisting in the knee also often causes the inner ligament to tear. In addition, rapid changes in direction and the occurrence after jumps or falls are associated with an increased risk of this torn ligament. The diagnosis of the inner ligament can be made clinically if the symptoms such as pain, swelling and bruising (haematoma) are considered together with the physical examination.

In the case of a torn ligament in the inner ligament, the joint space at the knee can be “opened” inwards, so to speak. It is important to know that the inner ligament is fused with the inner meniscus and is often injured together with the anterior cruciate ligament due to the injury mechanisms. Therefore, these injuries must always be clarified, and the MRI is a pioneering approach.

If the inner ligament is torn, the therapy is conservative, and surgery is rarely necessary. The affected person himself can do something immediately by cooling and elevating the knee. Then the knee is immobilized with bandages, splints or an orthosis.Any stress should be avoided at first and walking should be supported by walking aids.

Pain is treated with analgesics. Depending on the severity of the pain, the pause in exertion may last longer. At grade 1, light sport can be started again after about 2 weeks, grade 3 should not be loaded for at least 6 weeks.

Then a torn ligament is usually healed, accompanied by special physiotherapy to strengthen the muscles in the knee. Only in cases of complaints that do not improve despite therapy should surgery be considered. The outer ligament stabilizes the knee with the inner ligament and cruciate ligaments.

It pulls on the outside of the knee from the thigh to the calf head and stabilizes the knee by preventing the lower leg from bending outwards. If the elasticity in the outer ligament is exceeded, the ligament will tear. This happens when too much force is applied against the knee or upper lower leg from the inside.

Torn ligaments on the outer ligament occur less frequently than those on the inner ligament. In principle, the same mechanisms as for the inner ligament, i.e. twisting, falling and accidents, can cause an outer ligament to tear. Diagnostically groundbreaking are symptoms such as pain, swelling and bruising as well as possibly instability in the knee, where the joint gap “opens outwards” during the clinical test.

In case of doubt, an MRI must provide a reliable diagnosis. The therapy for a tear in the outer ligament is similar to the therapy for the inner ligament. It is performed conservatively.

The most important pillars of therapy are immobilization and protection, as well as elevation and cooling at the beginning. By attaching an orthosis to the knee, the joint is relieved and healing is promoted. Depending on the degree of severity, the knee must be relieved and splinted for 2 weeks in grade 1, for about 6 weeks in the case of a complete torn ligament (grade 3). Accompanying strengthening exercises of the muscles support the healing process.