Cruciate ligament and collateral ligament injuries

Help for cruciate ligament and collateral ligament injuries

The knee is the largest joint in the human body, and is exposed to severe stress presented by the requirements of daily doing and physical activity. Determining factors in joint stability itself are the cruciate ligaments and the collateral ligaments. The collateral ligaments are located on the outside of the knee joint, while the cruciate ligaments can be found within the joint structure itself. The collateral ligaments are primarily responsible for lateral stability and the cruciate ligaments prevent the frontal or posterior displacement of the tibia and the femur.

If a sudden contortion or twisting of the knee joint occurs, damage to the cruciate or collateral ligaments may result. Common causes for these types of injuries are accidents incurred during physical activity, such as those experienced while playing soccer or skiing. Ligament injuries to the knee joints can be very painful and may drastically affect the range of mobility and athletic prowess. Expedient and targeted treatment of knee injuries normally results in the restoration of mobility, freedom from pain, and the prevention of consequential damage.

The knee experts at the ECOM® Excellent Center of Medicine are specialized in the treatment of knee problems such as cruciate and collateral ligament injuries for professional athletes, amateur athletes, and for those leading less active lifestyles. Long-term experience has shown us: it is not always necessary to perform a surgical procedure in order to heal ligament injuries.

In many cases, injuries to cruciate and collateral ligaments can be treated successfully using conservative therapeutic methods. If a surgical procedure is necessary, it is customarily executed by our knee specialists using minimally invasive arthroscopic methods. Always with the goal of making rapid recovery and the conservation of mobility and athletic prowess possible.

What is an injury to the cruciate ligament?

Every knee has two cruciate ligaments: one anterior, one posterior. These ligaments cross diagonally and protect the knee joint during stretching, bending, or turning movements.

Every ligament is approximately as thick as a little finger (pinky finger) and can withstand the pressure produced by 200 Kg of force. Whereas the collateral ligaments can be probed and felt on either side of the knee, the cruciate ligaments are located deep within the joint structure itself.

The root causes for injuries to the cruciate ligaments are often sports injuries or other forms of trauma. The anterior cruciate ligament sustains a significantly higher number of injuries. In principle, every cruciate ligament is can be affected by overextension or sprains, and partial tearing or complete ruptures. Cruciate ligament ruptures are the most common and well-known form of ligament injuries.

In a case of a fresh ligament rupture, shooting pain is experienced at the moment of injury. Many affected hear a snapping sound which signals that something has torn or ruptured.

Symptoms often subside after a period of a few days and then recur, most often when the joint is exposed to pressure or exertion. Depending on the type of physical activity, injury to cruciate ligaments can often go undetected for longer periods of time. If timely treatment of the injury does not take place, long-term degenerative changes to the joint cartilage and/or meniscus damage may result.

What is an injury to the collateral ligament?

The knee joint is made stable not only by the cruciate ligaments, but is also supported by the upper sidebands or collateral ligaments, of which there are two: the medial collateral ligament and the lateral collateral ligament.

The medial collateral ligament is a flat, wide band measuring approximately 7 cm which reaches from the inner thigh down to the head of the tibia. It is responsible for stabilizing the knee when the leg is extended.

The lateral collateral ligament reaches from the exterior part of the thigh to the fibula. It is round and has the approximate diameter of a pencil and is as such thinner than the medial collateral ligament. When executing bending movements, it protects the knee from twisting and/or buckling.

Often, sports injuries and other forms of trauma are responsible for injuries to the collateral ligaments. The medial collateral ligament is affected much more frequently. Every collateral ligament can be subject to hyperextension, sprains, partial tears or complete ruptures. A typical situation resulting in injury to the lateral collateral ligament is caused by inward buckling during movement involved in rotation while playing football or skiing. When a lateral collateral ligament is injured, the knee joint is buckled outward after being exposed to extreme force. In this case, the most likely causes are sudden braking movements or wide lunges.

What are the symptoms of knee ligament injuries?

Knee ligament injuries are complex.  Depending on the extent of the injury, age, and overall physical health, the patient may experience different forms of discomfort. The most common symptoms of a ligament injury are pain and swelling. More severe injuries can lead to knee instability and the reduction of mobility. Frequently, pain is experienced when performing certain movements. If the affected joint is stable, walking and standing are normally possible despite a certain level of pain. Bruising normally only occurs when tissue has been injured.

Symptoms of collateral and cruciate ligament injuries

  • Pain
  • Swelling
  • Instability while walking
  • Reduced loadbearing capacity
  • Reduced ability to walk
  • Difficulties in executing stretching or bending movements
  • Bruising
  • Joint blockage

Pain caused by injuries to the collateral and cruciate ligaments may subside after a few days and only re-occur under physical exertion. In such cases, ligament injuries may remain undetected for years. Over the long-term, untreated injuries to these ligaments lead to knee joint instability. This may facilitate degenerative processes and increase the risk of knee arthrosis or other forms of knee injury, such as damage to the meniscus.

How is the treatment of injuries to knees ligaments carried out?

The extent of the injury, the instability of the knee joint, age and the patient’s occupational or athletic requirements are determining factors in any decisions about treatment procedures. As a general rule: not every cruciate ligament and collateral ligament injury requires a surgical procedure for successful treatment. Often, ligament injuries can be treated with success using conservative forms of therapy. The knee experts at ECOM® Excellent Center of Medicine come together to create an individual treatment and therapy concept comprised of a combination of pain management, physical therapy and orthopedic aids.

Pain management and therapy

  • Administered locally (pain relief ointment or gel)
  • Administered orally (pills or liquid form)

Physical therapy

  • Remedial gymnastics to help reconstruct muscle structures
  • Improvement of joint functionality
  • Cryotherapy
  • Ultrasound
  • Manual lymphatic drainage

Orthopedic aids

  • Walking aids (e.g. forearm braces)
  • Specialized splints to immobilize the knee
  • Knee braces

Surgical procedures for lateral or cruciate ligament injury treatment

  • Suturing preserves and conserves ligaments
  • Ligament replacement with endogenous implants
  • Ligament replacement with absorbable, biodegradable foreign implants

If conservative therapy does not produce the desired results, the knee specialists at ECOM® Excellent Center of Medicine recommended a surgical procedure as the best form of treatment for above all young patients and physically active adults. Joint stability is fully restored and possible subsequent damage such as arthrosis or meniscus lesions prevented.

Surgical procedures are usually done two to four weeks after the initial injury, as swelling and acute wounds must have time to heal. Operations are executed by the knee experts at ECOM® Excellent Center of Medicine with the benefit of a wealth of experience, with utmost precision, using minimally invasive arthroscopic methods.

Traditionally, torn or ruptured ligaments are sutured or replaced with endogenous ligament transplants during surgery. In a few select cases, an alternate form of treatment involves the implementation of a modern implant made of absorbable, biodegradable material. This supports the healing process in the same fashion as an endogenous implant, but does not remain in the body permanently. This method of treatment offers the patient decisive advantages, but not all types of injuries are suited for this approach.

It is up to the attending physician to decide which surgical procedure is best suited for each individual patient. Crucial factors for this decision are the location of the injury and physical requirements. Our guiding principle is always the rapid reduction of pain and the optimal restoration of mobility and athletic prowess. Individually-tailored rehabilitation therapy after the surgical procedure supports the healing process and facilitates regeneration.

What is the healing process after a knee ligament rupture?

A minimally invasive, arthroscopic procedure performed on the collateral or cruciate ligaments usually lasts between one and three hours. However, targeted rehabilitation measures are necessary to ensure that the patient regains full use and mobility of the affected knee.

The knee experts at the ECOM® Excellent Center of Medicine work in close collaboration with specially trained physical therapists to develop individual rehabilitation programs which support the healing process and optimize the regeneration process.

  • Usually, the affected limb is supported and protected by orthopedic aids for a period of 2 to 6 weeks after the operation.
  • After approximately 6 weeks training therapy begins, with the goal of increasing strength, coordination and endurance.
  • First training sessions on the bike ergometer, walking and low impact jogging are possible after a period of 6 to 10 weeks.
  • In cases of cruciate ligament replacement, sports disciplines requiring stop-and-go movements (soccer, basketball, tennis, etc.) as well as sports disciplines with a high injury risk level (skiing and snowboarding, in-line skating, etc.) should be avoided for a period of 6 to 8 months after the procedure.

Your specialists for cruciate ligament and collateral ligament injuries and other disorders

Dr. Rembeck

“Innovative, minimally-invasive methods such as arthroscopy for the treatment of ligament injuries help patients quickly resume athletic activity and daily doing”.

Dr. Erich Rembeck

Specialist for orthopedic, sports medicine


„The patient is often traumatized or in a state of shock. Targeted diagnostics and individual therapy are key factors for successful treatment“.

Dr. Alexander Rauch

Specialist for orthopedics and trauma surgery, sports medicine,  specialized trauma surgery


„Arthroscopic surgery has revolutionized the field of hip surgery and has paved the way to new, minimally invasive forms of treatment.“

Prof. Dr. Hans Gollwitzer

Specialist for orthopedics and trauma surgery
Specialist for orthopedics, sports medicine, chiropractic therapy

Consultation and contact data for questions about knee ligament injuries

Do you have any questions regarding the treatment and therapy of knee ligament injuries? Our knee specialists, Dr. Erich Rembeck and Dr. Alexander Rauch, will be happy to provide you with more information in an individual and personal appointment. Please make an appointment here. We are looking forward to seeing you.