18 August 2017
Knee ligament injuries in Premiership football last season reached such levels that one national newspaper even drew up a ‘First Eleven’ of players who spent part of last season on the treatment table.
But is it just professional footballers who are at risk or are amateur sports enthusiasts at all levels just as likely to suffer knee problems.
Spire Parkway Orthopaedic Consultant Surgeon Mr Mark Dunbar carried out knee fellowship training at Oxford where he focussed exclusively on problems affecting the knee and regularly performs knee ligament surgery, meniscal surgery and joint replacement surgery including revision knee surgery.
Here Mr Dunbar answers a few questions on knee and knee ligament injuries, how to avoid them and treatments available if surgery is the answer.
Which sports seem to result in the most knee injuries?
Any sports which involve planting one foot and suddenly changing direction of travel. Okay, so darts and snooker should be fairly safe but football, rugby, tennis – in fact most active sports – all represent a risk to the knees.
What is the most common knee injury and why?
Most knee injuries can be classified as ‘minor’ such as sprains and bruises. Having said that, other injuries such as meniscal cartilage tears, fractures of the bone and ligament ruptures are commonplace. The reason is that the knee is a very vulnerable joint as it carries all our body weight across the body’s longest levers - the bones of the legs. The result is that the knee has to transmit huge forces and undergo major impact on a regular basis so when we get those movements slightly wrong the injures can be quite severe.
Are professionals more at risk or do amateurs suffer the same amount of injuries?
It is difficult to know this for sure given the huge numbers of us who enjoy amateur sports. In all likelihood though, well trained athletes who warm up, have supple and muscular physiques which are perfected to their chosen sports are more likely to be able to soak up an injury which may cause us ‘mere mortals’ more serious damage.
Do they occur in ‘non-sporting’ people – particularly as they get older?
It tends to be the case that older people have plenty of sprains and strains, but more often than not it tends to be an exacerbation to symptoms of pre-existing wear and tear. Fewer will require surgery.
One injury that seems to get mentioned more than others in the Anterior Cruciate Ligament (ACL). Is this true and if so, why?
More minor injuries to the ligaments down the sides of the knee (collateral ligaments) are common and most can be managed with a non-operative strategy - meaning they will create fewer headlines. While the common ligament injuries may side-line a star striker for a few weeks ACL rupture could see them out of action for most of a year.
What treatments are available in the case of ACL damage?
If an individual wishes to return to the same level of sport, whether they are professional or not, they are quite likely going to require an ACL reconstruction operation. The reason for this is that the body relies on this ligament to stabilise the knee during these specific movements. My preferred technique is to use the patients’ own hamstrings tendons to recreate a new ligament. This is then passed across the knee joint where the original ligament was and held in place to give a stable knee.
What level of recovery can they expect from either operation?
Most patients are well motivated and do return to their chosen sports.
What sort of recovery can a person of reasonable fitness expect after ligament surgery?
Patients aim to return to running between 4-6 months and return to sports around 9 months or so. Extensive physiotherapy with a physiotherapist who understands the condition is essential.
The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.