Often resulting from the physical demands on the body by athletic activity, ligament tears
are serious injuries that can sideline an athlete for weeks. Only an orthopaedic surgeon,
such as Dr. Haar, can accurately diagnose and treat a torn ligament, and therefore, one
should be consulted when a ligament tear is suspected.
Ligaments are strong bands of tissue that stabilize the bones of a joint while still allowing
a limited range of motion. Ligaments are similar to tendons in that each are connective
tissues; however, while tendons connect muscles to bones, ligaments connect bone to bone.
How Do Ligament Injuries Occur?
Also known as a sprain, ligament injuries occur when a ligament is extended beyond its normal
range of motion, which is often the result of a traumatic injury. Commonly, traumatic
ligament overextension occurs during athletic activity, and includes the blunt force of a
football tackle and the twisting of a player quickly changing direction or landing awkwardly
from a jump. Ligament sprains and tears also can result from non-athletic trauma, such as a
fall or an awkward step onto an uneven surface.
Depending on the severity of the overextension, ligament sprains are classified into three
Grade I: Minor sprain (common in the wrist and
ankle) with symptoms of minimal tenderness and swelling (Grade 1 sprains can often be
treated non-surgically through rest and icing.)
Grade II: Moderate sprain with partial tearing of
the ligament (Accompanied by moderate pain, swelling, loss of joint function, and
bruising, Grade II sprains will likely require immobilization of the joint.)
Grade III: A complete tear of the ligament
Many ligaments lack the blood supply to self-heal, and a complete tear will often require
surgical intervention for proper and complete treatment, as well as to safeguard against
chronic re-injury of the joint.
Commonly torn ligaments include the ACL in the knee, ATFL of the ankle, and the UCL of the
elbow – all of which can be treated through arthroscopic methods.
Diagnosis & Treatment
If a severely torn ligament is suspected, an exam by an orthopaedic surgeon is the likely
first step to proper treatment. Along with a discussion about symptoms and medical history,
Dr. Haar will conduct a physical examination of the affected joint, likely comparing the
injured joint to its uninjured opposite and inspecting for abnormalities.
If further examination is required, imaging tests, such as an X-ray or MRI, may be ordered to
provide a more detailed assessment of the injury.
Arthroscopy is a minimally invasive surgical technique commonly utilized in the
reconstruction of torn ligaments. Utilizing a fiber-optic camera and in-OR monitor, Dr. Haar
is able to view the injured joint through only a minimal incision. With this optimal view of
the joint, Dr. Haar can accurately diagnose the extent of the injury and will likely repair
the torn ligament during the same procedure.
Ligaments cannot be healed by simply sewing the two ends back together. To properly treat a
ligament for long-term function, a tissue graft will be taken from either another part of
the patient's body or from a donor cadaver.
REHABILITATION AND RECOVERY
Arthroscopic techniques potentially provide the patient with several benefits compared to
traditional surgery. The minimally invasive approach to surgery reduces the damage to
tissues surrounding the injured joint. The reduction in collateral damage results in a
quicker recovery process from the surgery, along with less scarring from the small
Although the recovery process is shortened through the use arthroscopic surgical methods,
proper healing will still require a rigorous physical therapy regimen to strengthen the
injured joint and regain the joint's full range of motion. It typically takes patients 6 to
12 months to fully recover from a surgically repaired ligament injury.
Ligament Injury Treatment In New York
Dr. Robert Haar specializes in the arthroscopic treatment of ligaments, specifically within
the knee, shoulder, and elbow.
The knee is the largest joint in the body and one of the most complex as it supports most of our weight. If not for its powerful and strong ligaments, it would be very unstable. A breakage in one of these ligaments causes instability and unfavorably bends the knee in the direction of the lost grip. The cause of this type of injury can be a trauma (direct impact) or an improper and abrupt rotation of the joint like poor support during a jump, sudden stop in the race, rapid turn with the foot stuck in the ground, and more.
A ligament tear can range from a mild or simple tear to a complete tear, including intermediate injuries. The three most common degrees of ligament injury:
When a ligament tears you can feel a click and sometimes even hear it. A person with ligament injury goes through intense pain at the time of injury and in the following days. If the injury occurs to a cruciate ligament, there is usually an effusion of blood or spillage in the joint, accompanied with inflammation. If you try to walk with a ligament injury you can sense instability quite easily.
The knee is secured by the following four ligaments, that support the joint and limit its movements beyond bio-mechanical limits. Although all these ligaments are quite strong, they can at times stretch or tear.
External lateral ligament (LLE): It goes from the femur to the tibia and one of the two fascicles that make it up joins the medial meniscus. Its function is to prevent the knee from bending towards the inner side of the leg.
Internal lateral ligament (LLI): It joins the femur and the head of the fibula. It prevents the joint from deforming in the direction of the outer lateral.
Anterior cruciate ligament (ACL): Out of the four ligaments ACL is the one that provides greater stability to the knee. It prevents the femur from moving in relation to the tibia towards the back of the leg and controls the rotation of the leg. This is the one most frequently injured.
Posterior cruciate ligament (PCL): It intersects with the anterior ligament forming an X and prevents the femur from moving forward with respect to the tibia.
At the time of a knee ligament injury, pain can be soothed and inflammation reduced, by applying ice 4-5 times a day for the first 72 hours. Additionally, a hinged knee brace must be used to support the leg and maintain knee stability. The patient should be given proper rest with the leg elevated, in order to promote blood circulation. Anti-inflammatory medications can also be taken to ease the pain.
From there, the type of torn ligament treatment will depend on the severity of the injury, which will be determined by performing an MRI. In the mildest cases of ligament rupture (sprains or tears), the ligament could heal on its own, with the help of a rehabilitation program. However, when the rupture is severe, ligament surgery (arthroscopy) is an unavoidable therapeutic option, since the torn ligament needs to be reconstructed. Also, physical therapy will have to be done as soon as possible.
Ligaments are made up of several fibers, and in some cases not all of them are torn, which influences the severity of the injury in question. After torn ligament treatment, if the reconstruction is primary and there are no associated injuries, it usually takes 4 to 8 weeks for the patient to return to normal day-to-day activities, however, resuming sports or heavy exercises is still not recommended. Your complete recovery cycle depends on the severity of the injury, the activity and physical condition prior to the injury, accompanied by the procedures of both treatment and rest followed in the proper way.