7 signs of a cruciate ligament tear that should not be confused with a simple sprain

a bad landing after a jump, a sudden turn on the futsal court or a slip on the stairs; A few seconds later, the knee swells and you feel like you don't trust it anymore. Many people mistake this moment for a normal sprain, wait a few days and go back to training when the swelling subsides. This simple decision can turn a torn ligament into a meniscus and cartilage injury.

In this article, with the help of the clinical experience of Dr. Hirsh Heidari, a knee and shoulder surgeon with an additional course in arthroscopy in Germany, we review the symptoms that indicate that your knee injury is more serious than a simple sprain.

What is the cruciate ligament and why does it tear?

The anterior cruciate ligament is a strong band in the center of the knee that connects the femur to the leg. Its job is to prevent the leg from sliding forward or rotating too much in relation to the thigh.

Most ruptures occur without hitting anyone. The three risky moves are:

Rotation on the fixed leg: the leg is locked on the ground and the body rotates; Common in football, futsal and basketball.

Landing with straight or bent knees: after a jump in volleyball, handball, or gymnastics.

Sudden stop while running: changing direction quickly or braking on one leg.

Female athletes are exposed to this injury many times more than men; The reason is a combination of hip angle, landing pattern and the difference in the strength of the back and front thigh muscles.

A cracking sound or tearing sensation at the moment of injury. Many patients say that they heard a sound like a wood breaking inside the knee.

Rapid swelling in the first few hours. Bleeding inside the joint causes the knee to swell usually within 2 to 12 hours; The swelling that appears the next day is more likely to be caused by milder injuries.

Empty the knee. When going down the stairs or turning, the knee momentarily comes out from under the body.

Inability to continue playing. An athlete who could not return to the field after an injury should be seriously examined.

Limitations in straight or full knee flexion. Swelling and pain do not allow the leg to be completely straightened.

Pain in the joint line. The pain felt on the sides of the knee is sometimes a sign of meniscus damage.

Weakness and thinning of the front thigh muscle. In old, untreated tears, the quadriceps muscle becomes noticeably weaker after several weeks.

If you have experienced the first three cases together, the possibility of rupture of the cruciate ligament is high and do not postpone the specialist examination.

Cruciate ligament tear, sprain or meniscus injury?

This table does not take the place of examination; In many patients, ligament tears and meniscus damage occur together.

What tests does the doctor use to diagnose a tear?

The main diagnosis is by examining the surgeon's hand and imaging completes it.

Lockman test: the knee is slightly bent and the doctor pulls the leg forward; Abnormal looseness and lack of a firm stop indicate a tear. This test is one of the most accurate clinical examinations for the cruciate ligament.

Anterior drawer test: same idea with knee bent 90 degrees.

Pivot shift test: a rotating movement that recreates the feeling of emptying the knee; It is usually done when the swelling and pain are reduced.

MRI: In addition to confirming the tear, it shows accompanying injuries such as meniscus tears, bone bruises, and cartilage damage, and is essential for planning surgery.

Doing these tests at home is not recommended; Improper pressure on the swollen knee increases the pain and is not reliable.

What to do in the first 48 hours after the injury?

Take the weight off your feet and use crutches if walking is painful.

Place an ice pack on your knee with a thin towel for 15 to 20 minutes several times a day.

Keep the leg above the level of the heart when sitting and sleeping.

Avoid heat, firm massage, and trying to "open" the knee with forceful movements.

Make an appointment for an examination as soon as possible; The examination is more accurate in the first days.

When should you see a doctor immediately?

If the knee is locked at an angle and won't open, the leg is cold, pale, or numb, the knee has changed shape, or the pain isn't controlled with regular pain relievers, don't delay and go to the emergency room the same day.

Does a cruciate ligament tear always require surgery?

not always The decision depends on age, activity level, degree of instability and associated injuries. An immobile person with a partial tear may lead a normal life with physical therapy and muscle strengthening.

But for athletes, young people, and those whose knees constantly give out, ligament reconstruction is usually recommended. Every time emptying the knee means a new blow to the meniscus and cartilage; An injury that can later lead to early arthritis.

For this reason, choosing a surgeon is very important. If you are looking for the best cruciate ligament surgeon in Tehran, ask for specialized experience in arthroscopy and surgical procedures. Dr. Hirsh Heydari completed the supplementary course of cruciate ligament arthroscopy in Germany and performs ligament reconstruction using the All-Inside method. The way that the graft is fixed with special buttons and does not require screws inside the bone.

Is it possible to walk with a torn cruciate ligament?

Yes, many patients walk after the swelling subsides. This issue prevents serious damage; The main problem is turning, running and stepping, not straight walking.