Knee ligament repair

Knee ligaments are the short bands of tough, flexible connective tissue that hold the bones of the knee joint together.

Knee ligament injuries can be caused by trauma, such as a car accident or fall, or by a sports injury, like a football tackle or a sudden twist while skiing. Damage to the knee’s anterior cruciate ligament (ACL) is the most common injury we treat, but our specialists can repair all of the four knee ligaments.

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Types of knee ligaments and injuries

Your knee has four major ligaments, with two types:

  • Collateral ligaments are found on the sides of the knee. The medial collateral ligament (MCL) gives stability to the inner knee. The lateral collateral ligament (LCL) gives stability to the outer knee. The MCL is injured more often than the LCL because stretch and tear injuries are usually caused by a blow to the outer side of the knee, as in hockey or football.
  • Cruciate ligaments are found through the middle of your knee joint. They cross each other to form an “X” with the anterior cruciate ligament (ACL) in front and the posterior cruciate ligament (PCL) in back. The cruciate ligaments control the back and forth motion of your knee, as well as the rotation of the knee. The ACL can be commonly injured, including being stretched or torn, during activities that involve twisting and pivoting, such as skiing, basketball, soccer and football.

Knee ligament injuries present with pain, swelling, buckling and often a popping sound at the time of injury, and you may not be able to walk on that knee. You might notice instability when trying to walk on it afterward. Injured ligaments are called sprains and are graded on a severity scale:

  • Grade 1. The ligament has been slightly stretched, but the knee joint is stable.
  • Grade 2. The ligament has been stretched to the point where it becomes loose—often referred to as a partial tear of the ligament.
  • Grade 3. Most commonly referred to as a complete tear of the ligament, as the ligament has been torn into two pieces and the knee joint is unstable.

It is possible to injure two or more ligaments at the same time, which can have serious complications. Surgery is necessary to restore stability in these cases.

Surgical and nonsurgical treatment options

Your provider will work with you on the right treatment plan for your case. At first, you can try pain relievers and the RICE method at home:

  • Rest your knee by not walking on it.
  • Ice your knee to help pain and swelling.
  • Compress your knee by wrapping it with a bandage or wearing a sleeve.
  • Elevate your knee.

Your plan may also include other nonsurgical options:

  • Physical therapy including muscle-strengthening and motion exercises
  • Protective knee brace
  • Activity limitations for a brief period of time

We can successfully treat many PCL and MCL injuries without surgery. However, if these treatments don’t work, or your injury is a high grade or you have multiple ligament injuries, we may recommend surgery to fix the issue.

The surgery to correct a torn knee ligament may involve replacing the damaged ligament with a piece of healthy tendon, called a tendon graft, often taken from another part of the knee. The tendon graft may come from the patient, called an autograft, or from a donor, called an allograft. We perform most ligament repairs arthroscopically, but some cases may require open surgery.

Rehab for your repaired knee

Physical therapy will be critical part of your personalized treatment plan. It will help you regain strength in your ligaments and muscles, and may be all the treatment you need.

If you had surgery, physical therapy will begin one to six weeks after your procedure. We will help you get back to your favorite activities and sports as soon as possible.


Orthoinfo: American Academy of Orthopaedic Surgeons. Combined Knee Ligament Injuries ––conditions/combined-knee-ligament-injuries/

MedlinePlus: National Library of Medicine. Collateral ligament (CL) injury –