Meniscus and Ligament Injuries of the Knee
In sports injuries, the meniscus and ligaments are often damaged together. Assessing every structure properly is essential to protect the knee in the long term.
The knee is stabilised by four main ligaments and two menisci. In sport, twisting, sudden stops or contact can injure one or several of these structures at once. Identifying every injured structure is important for successful treatment and for the knee’s future.
The ligaments and menisci of the knee
- Anterior cruciate ligament (ACL): Prevents the shin bone from sliding forward and controls rotational instability.
- Posterior cruciate ligament (PCL): Prevents the shin bone from sliding backward. Usually injured by a blow to the front of the knee.
- Medial collateral ligament (MCL): Resists the knee bending inwards. Often injured in contact sports.
- Lateral collateral ligament and posterolateral corner: Resist the knee opening outwards and rotating.
- Menisci: Two cartilage cushions that spread load and absorb shock.
Symptoms
A pop at the moment of injury, rapid swelling, the knee giving way, inability to bear weight, locking and pain on the inner or outer side are common. Symptoms vary depending on which structure is injured.
Diagnosis
A detailed examination tests each ligament separately. X-rays rule out fractures, and MRI assesses ligament, meniscus and cartilage damage together. When several ligaments are injured, checking the blood vessels and nerves is also important.
Treatment approach
MCL injuries
Most MCL injuries heal without surgery, using a brace that controls movement and physiotherapy.
ACL tears
Arthroscopic reconstruction is usually recommended for active patients. See our ACL reconstruction page for details.
PCL injuries
Many isolated PCL injuries can be managed with physiotherapy. Reconstruction is needed when there is marked instability or other ligaments are also injured.
Meniscus tears
Suitable tears are stitched to preserve the meniscus; when a tear cannot be repaired, only the damaged part is removed.
Multi-ligament injuries
In severe injuries involving several ligaments, surgery is planned and timed carefully, sometimes in stages.
Recovery and return to sport
Rehabilitation includes reducing swelling, regaining range of motion, building muscle strength and balance and agility work. Returning to sport is planned once strength and functional tests are complete.
How can injuries be prevented?
Warming up, leg-strengthening exercises, jump-landing technique and balance training reduce the risk of knee injuries. Injury-prevention programmes like these are recommended especially in football, basketball and handball.
Frequently asked questions
My knee swelled but the pain has eased. Should I still be examined?
Yes. Swelling that develops quickly after an injury often means bleeding inside the joint and a significant ligament or meniscus injury. Less pain does not mean the injury has healed.
Is a knee brace enough for a ligament tear?
For some injuries, such as MCL tears, a brace and physiotherapy are enough. For ACL tears, a brace alone does not correct the instability.
Do I need an MRI?
In sports injuries where several structures may be damaged, MRI is very important for planning treatment correctly.
The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.