Sports & ski injuries.

How these injuries happen

The anterior cruciate ligament (ACL) runs diagonally through the middle of the knee and stops the shin bone sliding forward on the thigh bone. It is most often injured by a twist on a planted foot, such as a skiing fall, a rapid change of direction, or an awkward jump or landing. Most people feel a pop, followed by pain, swelling and a knee that no longer feels trustworthy. The posterior cruciate ligament (PCL) and medial collateral ligament (MCL) are also vulnerable, particularly in skiing falls and direct blows to the front or side of the knee.

Getting a diagnosis

A careful examination of both knees, including the Lachman and pivot shift tests, usually tells the story, with X-rays and MRI confirming the diagnosis and picking up any damage to the menisci or other ligaments alongside.

Treatment

Not every ligament injury needs an operation. Where the knee can be stabilised, bracing and targeted physiotherapy to strengthen the quadriceps and hamstrings may be all that is required. Where surgery is the right choice, the ligament is reconstructed arthroscopically using a graft of your own tendon, often combined with meniscal repair or a lateral extra-articular tenodesis (LET) where extra rotational control is needed. Both ACL and PCL ruptures can be reconstructed this way, while many MCL tears heal well in a hinged brace. Combined multi-ligament injuries are planned and treated as a single procedure.

Recovery

Rehabilitation is where the result is made. A structured programme rebuilds strength and agility step by step, with a return to competitive sport typically from nine to twelve months.