The knee is a hinge joint that connects four main bones: the femur (thigh bone), the tibia and fibula (shinbones), and the patella (kneecap). The ends of the tibia and femur, as well as the posterior of the patella, are covered in tough connective tissue known as articular cartilage.
This provides a smooth gliding surface that reduces friction between the bones of the knee joint, and facilitates smooth movement. The knee also has two C-shaped, rubbery pads of cartilage tissue covering the top of the tibia that are known as the medial and lateral menisci. The menisci serve as shock absorbers for the impact of the upper and lower knee. The knee has four ligaments that stabilize and support the knee in different positions.
Each of the knee ligaments serves a particular function.
- Medial Collateral Ligament (MCL): the MCL runs between the femur and the tibia on the inner side of the knee. This limits the lateral (side to side) movement of the knee joint, and is most commonly injured from force that hits the outer side of the knee.
- Lateral Collateral Ligament (LCL): the LCL runs between the femur and the fibula on the outer side of the knee. Similar to the MCL, the LCL also stabilizes the knee against lateral movement. It is most commonly injured from force that hits the inner side of the knee.
- Anterior Cruciate Ligament (ACL): the ACL is inside the knee joint, and runs diagonally across the knee to connect the anterior portion of the tibia to the posterior of the femur. It controls the backward and forward movements of the knee, and prevents the tibia from moving in front of the femur.
- Posterior Cruciate Ligament (PCL): the PCL is also inside the knee joint, and runs diagonally across the knee to connect the posterior of the tibia to the anterior portion of the femur. Similar to the ACL, the PCL controls the backwards and forward movements of the knee.
Each of the ligaments is at risk for injury, particularly following sudden movement or impact to the knee. This can occur following falls, an awkward landing, or even from an outside force, such as tackling. Injuries to the knee ligaments are more common among athletes and other people in high-risk professions and sports.
Knee ligament injuries will depend on the severity of the damage received. Injured ligaments are referred to as “sprains”, and can range from stretching, to partial, and even complete tears. These are graded on a severity scale as follows:
- Grade 1 Sprain: The ligament is mildly damaged due to slight stretching, but is still capable of maintaining stability of the knee joint.
- Grade 2 Sprain: This is more commonly known as a partial tear of the ligament. This injury is characterized by the ligament being stretched to the point of looseness. The stability of the knee is compromised.
- Grade 3 Sprain: This refers to a complete tear of the ligament. In this injury, the ligament is completely separated into two pieces, and the knee joint becomes unstable.
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