Ligament Injuries After a Car Accident: A Patient's Journey

Ligament issues

Hello Dr.
Chen Yong-Hsueh, I would like to inquire about an injury I sustained in a car accident.
I experienced a significant impact, which resulted in an injury to my right knee.
The diagnosis at that time was as follows: "According to the diagnostic certificate from Tien Cheng Hospital: abrasions on both elbows, abrasions on both hands, abrasion on the right hip, contusion on the right ankle, and a 2 cm laceration on the right knee." However, since only an X-ray was performed in the emergency department, it was not possible to determine if there was any ligament damage.
After being bandaged, I was sent home.

After 6-7 months, I noticed a feeling of instability in my leg while walking, along with deep pain in my knee.
A few days later, I went to the hospital for a check-up and was diagnosed with a torn posterior cruciate ligament.
I would like to know if there is a causal relationship between the accident and this injury, as the location corresponds with the area that was injured in the accident, and I had never experienced such issues in my previous medical records.
I would greatly appreciate your clarification on this matter! Thank you very much!

Witney, 30~39 year old female. Ask Date: 2019/10/30

Dr. Chen Yongxue reply Orthopedics

Hello, an anterior cruciate ligament (ACL) tear is often difficult to diagnose in the early stages due to swelling in the knee joint.
Typically, a definitive diagnosis can only be made after the swelling subsides and a physical examination is conducted.
Ultimately, confirmation of the diagnosis often relies on magnetic resonance imaging (MRI) and arthroscopic surgery.

Reply Date: 2019/10/30

More Info

In your case, it appears that you sustained a significant injury to your right knee during the car accident, which was initially diagnosed as a laceration. However, the absence of an MRI or other advanced imaging studies at that time may have led to an oversight regarding the potential involvement of ligaments, particularly the posterior cruciate ligament (PCL) or anterior cruciate ligament (ACL).
Ligament injuries, especially those involving the ACL or PCL, can sometimes be subtle and may not present immediate symptoms. It is not uncommon for patients to experience delayed symptoms, such as instability or pain, several months after the initial injury. This is particularly true if the injury was not thoroughly evaluated with appropriate imaging techniques. In your case, the fact that you experienced a sensation of "walking on air" and deep pain in the knee suggests that there may have been underlying ligament damage that was not detected during your initial evaluation.

The relationship between your car accident and the subsequent diagnosis of a torn ligament is indeed plausible. The mechanism of injury from a car accident can lead to significant stress on the knee joint, potentially resulting in ligament tears. The timeline you provided, where symptoms developed several months post-accident, aligns with common presentations of ligament injuries.
To further clarify the situation, it is essential to consider the following points:
1. Imaging Studies: An MRI is the gold standard for diagnosing ligament injuries. If you have not yet undergone an MRI, it is highly recommended to do so. This imaging will provide a clear view of the soft tissues, including ligaments, and help confirm the diagnosis of a torn ligament.

2. Treatment Options: If a ligament tear is confirmed, treatment options may vary based on the severity of the injury. In some cases, physical therapy may be sufficient to regain strength and stability in the knee. However, more severe tears, particularly of the ACL or PCL, may require surgical intervention.

3. Physical Therapy: Regardless of the treatment path, engaging in physical therapy can be beneficial. A physical therapist can help you strengthen the muscles around the knee, improve range of motion, and enhance overall function. This is crucial for recovery, especially if surgery is indicated.

4. Follow-Up Care: It is important to maintain regular follow-up appointments with your healthcare provider. This will allow for ongoing assessment of your knee's stability and function, and adjustments to your treatment plan as necessary.

5. Documentation: Keep thorough records of your injuries, treatments, and any changes in symptoms. This documentation can be valuable for both medical and potential legal considerations related to your car accident.

In conclusion, there is a reasonable basis to believe that your knee injury is related to the car accident, particularly given the mechanism of injury and the subsequent development of symptoms. It is crucial to pursue further evaluation and treatment to ensure optimal recovery and to address any lingering issues related to your knee. Please consult with an orthopedic specialist who can guide you through the necessary steps for diagnosis and rehabilitation.

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