Ligament Injuries: Knee Pain and Treatment Options

Ligament issues

Hello, doctor.
I would like to ask about an injury I sustained approximately three years ago when I was about 15 years old while playing basketball.
At that time, I completely ignored it, thinking it was not serious, and continued to play with the injury for a long time.
It wasn't until about a year later that I went to see a doctor and had X-rays and an MRI done.
The doctor said there was not much of a problem, but if I wanted further confirmation, I would need to undergo arthroscopy.
I have been enduring the pain for a long time and have largely ignored it.
Now that I am 18 and looking for a job, I have realized the importance of my knee.

The symptoms I experience include pain when squatting, going up and down stairs, and running.
My knee feels unstable, and I am uncertain whether the pain is coming from the lateral collateral ligament, the meniscus, or the cruciate ligament.
A long time ago, I did some exercises to strengthen my quadriceps, which provided some improvement.
I believe that ignoring the initial strain caused me to miss the golden period for self-repair.
Even normal walking has been affected, and it has severely impacted my daily life.
For the past two years, I have not engaged in any intense physical activity because I will be working in auto repair, which requires prolonged squatting.

Is there a possibility of surgical treatment? I would appreciate your guidance, doctor.

Mr. Hou, 10~19 year old female. Ask Date: 2018/06/28

Dr. Chen Yongxue reply Orthopedics

Hello, your current symptoms seem to be quite bothersome.
Please visit the orthopedic outpatient clinic for further evaluation.
We will conduct a physical examination, as well as X-rays and MRI for additional assessment.
Thank you.

Reply Date: 2018/06/28

More Info

Knee injuries, particularly those involving ligaments, can significantly affect daily activities and overall quality of life. Based on your description, it seems that you have been dealing with knee pain for several years, stemming from an initial injury while playing basketball. The symptoms you are experiencing—pain during squatting, climbing stairs, running, and a feeling of instability—are common indicators of ligament injuries, particularly involving the collateral ligaments or possibly the meniscus.

Understanding Your Condition
1. Ligament Injuries: The knee is stabilized by several ligaments, including the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). Injuries to these ligaments can lead to instability and pain. Given your history of playing basketball and the subsequent pain, it is possible that you have sustained a partial or complete tear of one of these ligaments.

2. Meniscal Injuries: The meniscus acts as a cushion between your thigh bone and shin bone. A tear in the meniscus can also cause pain, swelling, and difficulty moving the knee. Symptoms like clicking or locking of the knee may indicate a meniscal tear.

3. Delayed Treatment: You mentioned that you initially ignored the injury and continued to play, which can lead to chronic issues. Ligaments and cartilage have a limited capacity for self-repair, and delaying treatment can result in further degeneration and complications, making recovery more challenging.

Treatment Options
1. Conservative Management: Initially, conservative treatments such as physical therapy, rest, ice, compression, and elevation (RICE) can help manage symptoms. Strengthening exercises for the quadriceps and hamstrings can also provide support to the knee joint.

2. Physical Therapy: Engaging in a structured physical therapy program can help improve strength, flexibility, and stability in the knee. A physical therapist can tailor a program specific to your needs, focusing on exercises that enhance muscle support around the knee.

3. Surgical Options: If conservative management does not provide relief and your symptoms persist, surgical intervention may be necessary. Arthroscopic surgery can be performed to repair or reconstruct damaged ligaments or to address meniscal tears. The decision for surgery typically depends on the severity of the injury, your activity level, and the impact on your daily life.

4. Post-Surgery Rehabilitation: If you opt for surgery, a comprehensive rehabilitation program will be crucial for recovery. This typically involves gradual progression from passive range of motion exercises to more active strengthening and functional activities.

Considerations for Your Future
- Activity Modification: Given your future career in auto repair, which may require prolonged squatting, it is essential to consider how to modify your activities to avoid exacerbating your knee pain. Ergonomic tools and techniques can help reduce strain on your knees.

- Knee Bracing: While knee braces can provide support, they should be used judiciously. If you experience discomfort while wearing a brace, it may be worth consulting with a specialist to find a more suitable option.

- Regular Follow-ups: Since your condition has persisted for several years, regular follow-ups with an orthopedic specialist are advisable. They can monitor your knee's condition and adjust your treatment plan as necessary.

Conclusion
In summary, your knee pain and instability are likely related to previous ligament injuries, and it is crucial to address these issues proactively. Consulting with an orthopedic surgeon who specializes in sports medicine may provide you with the best options for treatment, including the possibility of surgery if warranted. Early intervention can help restore function and allow you to engage in your desired activities without pain.

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