The term Unhappy Triad refers to a combination injury of three structures in the knee joint: The reason is usually a sports injury with a fixed foot and excessive outward rotation – often found in skiers and footballers. The diagnosis of an Unhappy Triad can be confirmed using imaging techniques such as X-rays or MRI.
- Front cruciate ligament
- Inner strip
- Inner meniscus
OP
Since three of the structures that provide stability are torn in an Unhappy Triad and mostly athletes are affected who will again expose their knee to great stress, the injury is usually operated on. In addition, a lack of stability in the long term can cause consequential damage such as joint arthrosis. In order to replace the torn ligaments, the body’s own tendon material is removed from another site and inserted into the knee, or the torn structures are rejoined and sutured together. Surgery is performed either in the first hours after the injury has occurred or after a few days, when the typical signs of inflammation such as severe swelling, overheating, redness, severe pain and functional impairment have subsided.
History
The course after an Unhappy Triad injury or its surgery can be quite lengthy. The inner ligament is quite well supplied with blood, which means that we find a higher metabolic activity and therefore a better and faster healing, but the anterior cruciate ligament and parts of the inner meniscus are hardly supplied with blood and therefore heal much worse and slower. The healing of the Unhappy Triad proceeds in the body like any other tissue injury after the wound healing phases – the body’s own repair system. According to the classical classification, wound healing is initiated with the inflammatory phase (day 0-5), followed by proliferation (day 5-21), in which the signs of inflammation such as swelling and pain decrease and new tissue is formed, and finally the consolidation phase (day 21-360), in which the new fibers solidify and the injury heals until the old function is restored. The classic guidelines vary, however, depending on the individual’s state of health and the location of the injury – which, as mentioned above, in the case of tissues with poor blood supply, can have a negative effect in the long term.
All articles in this series:
