The knee is one of the most important and complex parts of the body, playing a vital role in our daily mobility and stability. However, when participating in sports activities that require intense or sudden movements, the ligaments around the knee can become susceptible to injury. These ligaments are important structures that connect bones to each other, providing stability and supporting knee movement.
The knee is a weak structure, but is supported by several structures, namely:
- Quadriceps femoris : a complex of four muscle components that attach to the patella via the quadriceps tendon.
- Fibrous capsule : is a dense outer tissue that prevents dislocation of the knee when the body is twisted. The fibrous capsule attaches to the femur proximally, the tibia distally, and the intercondylar fossa posteriorly. The fibrous capsule has a synovial membrane lining.
- Extracapsular ligaments include:
- Patellar ligament: extends from the patella inferiorly and attaches distally to the anterosuperior aspect of the tibia. This ligament strengthens the capsule anteriorly.
- Fibular collateral ligament or lateral collateral ligament (LCL): extends inferiorly from the lateral femoral epicondyle to the lateral surface of the fibular head. This ligament prevents varus stress on the knee.
- Tibial collateral ligament or medial collateral ligament (MCL): extends from the medial femoral epicondyle to the medial condyle and the superomedial tibial surface; usually firmly attached to the medial meniscus. This ligament prevents valgus stress on the knee.
- Oblique popliteal ligament: a continuation of the semimembranosus tendon, this ligament functions to strengthen the fibrous capsule in the posterior part.
- Arcuate popliteal ligament: originates from the posterior border of the fibular head, extends superomedially over the popliteus tendon, and occupies the posterior aspect of the knee joint.
- Intra-articular ligaments, including:
- Anterior cruciate ligament (ACL): originates from the anterior tibial intercondylar area behind the medial meniscus attachment and inserts onto the posteromedial surface of the lateral femoral condyle. This ligament prevents hyperextension of the knee, posterior femoral displacement, and anterior tibial displacement of the knee when flexed. This ligament is a weaker cruciate ligament with poor blood circulation.
- Posterior cruciate ligament (PCL): originates from the posterior tibial intercondylar area and inserts on the anterolateral aspect of the medial femoral condyle. This ligament tightens during knee flexion and prevents hyperflexion and posterior tibial displacement. This ligament is a stronger cruciate ligament compared to the ACL and functions to support body weight when the knee is flexed.
- Medial and lateral menisci: are fibrocartilaginous structures located between the tibiofemoral articular surfaces. The menisci function as shock absorbers, static stabilizers, and friction dampers during articulation.
A study conducted by R. John, et al in 2016 showed the epidemiology of knee injury cases in athletes in India. In the study, it was found that from 363 samples, 314 cases of ACL injuries, 284 cases of meniscus injuries, 133 cases of collateral ligament injuries (MCL and LCL), and 10 cases of PCL injuries were found.
From the data above, several factors can influence the occurrence of injuries, such as the mechanism of injury, type of sport, and level of competition of the athlete. In addition, biomechanics and characteristics of each tissue also influence the injuries that occur.
Given how vital the knee is to everyday activities and sports, it is important for us to understand and implement effective injury prevention strategies. With a structured and planned injury prevention program, we can reduce the risk of knee ligament injuries and maintain our knee health in the long term.
By focusing on strengthening the muscles around the knee, increasing flexibility, correct exercise technique, and using appropriate protective equipment, we can help protect our knees from injuries that can interfere with our daily activities and overall quality of life.
So let’s commit to adopting the right injury prevention strategies, both for those of us who participate in intense sports and for the maintenance of our knee health in general. With the right attention and care, we can keep our knees strong, healthy, and ready to face whatever challenges we face in the future.
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Reference :
- Gupton M, Imonugo O, Black AC, et al. Anatomy, Bony Pelvis and Lower Limb, Knee. [Updated 2023 Nov 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK500017/
- John R, Dhillon MS, Syam K, Prabhakar S, Behera P, Singh H. Epidemiological profile of sports-related knee injuries in northern India: An observational study at a tertiary care centre. J Clin Orthop Trauma. 2016 Jul-Sep;7(3):207-11. doi: 10.1016/j.jcot.2016.02.003. Epub 2016 Feb 28. PMID: 27489418; PMCID: PMC4949405.