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      <h2><!-- #BeginEditable "title" -->Knee Ligament Injuries (Sprains) <!-- #EndEditable --></h2>
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    <td><!-- #BeginEditable "content" --> <img src="img/kli.gif" align=right border=0 alt="Knee ligament injury"> 
      <p><b>What are knee ligament injuries?</b></p>
      <p>The stability of the knee is dependent on powerful muscles which act 
        as active restraints, and four strong ligaments which act as passive restraints. 
      <p>The four ligaments are as follows. 
      <ol>
        <li>The <a name=mcl><i>medial collateral ligament (MCL)</i></a> prevents 
          the knee from buckling inwards (or valgus injury). 
        <li>The <a name=lcl><i>lateral collateral ligament (LCL)</i></a> prevents 
          the knee from buckling outwards (or varus injury). 
        <li> The <a name=acl><i>anterior cruciate ligament (ACL)</i></a> prevents 
          the tibia from sliding forwards under the femur. 
        <li>The <a name=pcl><i>posterior cruciate ligament (PCL)</i></a> prevents 
          the tibia from sliding backwards under the femur 
      </ol>
      <p>Together , these ligaments also provide rotatory stability to the knee, 
        which is important in running sports like football and soccer where cutting 
        (sudden change of direction while running at great speed) is often needed. 
      <p>Ligament injuries (sprains) are classified according to severity as follows. 
      <ol>
        <li>Grade I - mild - where the ligament is stretched, but only a few fibers 
          are disrupted 
        <li>Grade II - moderate - where the ligament is partially disrupted 
        <li>Grade III - severe - where the ligament is totally disrupted and there 
          is instability. 
      </ol>
      <p><b>What does your doctor do about knee ligament injuries?</b> 
      <p>Ligament injuries are very common in adults and mature adolescents, but 
        less common in young children. In children, the ligaments are stronger 
        than the epiphyeal plates ( growth plates), so that any extraneous force 
        on the knee tends to disrupt the epiphyseal plate causing <a href=epiphyseal.html>epiphyseal 
        plate injuries</a> rather than the ligaments. 
      <p>X-rays will distinguish the epiphyseal plate injuries from the ligament 
        injuries. Stress X-rays can help determine the severity of the ligament 
        injury, and the stability of the knee. MRI may sometimes be needed to 
        check for any other intra-articular injuries. 
      <p>Grade I and II sprains can be treated conservatively with a cast or a 
        brace followed by exercises to regain mobility and strength. (see the 
        <a href="http://www.wheatonbrace.com/products/airpro_basic.html" target="_blank">AirPro™ 
        Basic Knee Support</a>) 
      <p>Grade III sprains usually require surgical repair followed by casting 
        and intensive rehabilitation before the athlete can return to sports. 
        This process may take about 12 weeks. 
      <p>Cruciate ligament tears are not amenable to direct repair, and may require 
        reconstruction at a later date. The decision to undertake reconstruction 
        should be taken seriously, since the process of surgery and rehabilitation 
        is arduous, and may take up to a year before return to sports. Factors 
        to consider include age and aspirations of the patient. </p>
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      <p><font size="-1"><i>NOTICE: The information presented is for your information 
        only, and not a substitute for the medical advice of a qualified physician. 
        Neither the author nor the publisher will be responsible for any harm 
        or injury resulting from interpretations of the materials in this article.</i></font></p>
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