It is coming up to a busy sports season: football, soccer, netball, skiing etc. This newsletter is to bring you up to date with current methods of assessment and management and also to help you understand when it is important to refer such cases to an experienced knee surgeon with a degree of relative urgency.

Acute knee injury:

The classic history for an acute ACL (anterior cruciate ligament) tear is a weight bearing, rotating injury to the knee. It is often not associated with contact. The Knee will usually but not always swell. Often a pop or tear is felt.

ACL-tear-18

Following the injury, most patients find it difficult to weight bear and often attended Emergency where an X-ray is performed and usually misleading and normal.

Many ACL tears are associated with an injury to another structure(s) of the knee. The common zones of injury are 1. Medial collateral ligament 2. Lateral meniscus

The easiest way to assess these complex injuries is to refer for an MRI scan. Most patients these days either expect or insist on this investigation, which can usually be organised on the same day as there are more than adequate scanners in most areas.

Urgent matters include:

1. Repairable meniscal lesions
2. Acute tears of the MCL that are associated with instability
3. Combined injuries such as ACL plus MCL plus PCL