Exploring the Cruciate Ligament: Anatomy, Function, and Common Injuries

Anatomy of the Cruciate Ligament (1)

Ligaments are fibrous connective tissues that link two bones, cartilages, or joints. They provide strength, connectivity, flexibility, and stability. The cruciate ligament is an essential part of the human body that stabilizes the knee, and it consists of two primary ligaments:

1.      Anterior Cruciate Ligament (ACL)

The ACL connects the thigh bone (femur) with the shinbone (tibia) to support the knee joint.

2.      Posterior Cruciate Ligament (PCL)

The PCL also connects the femur and the tibia but is positioned at the back of the knee.

Both of these ligaments meet in an “X” shape at the middle of the knee joint, which indicates the name cruciate; meaning cross.

Function of the Cruciate Ligament (2)

1. The cruciate ligament provides stability and balance to the knee joint.
   
2. It allows smooth and controllable movement abilities, such as walking, jogging, and running.
   
3. The ACL restricts anterior tibial dislocation with the femur.
4. The ACL is important in movements that require sudden changes in direction or stopping, and maintains internal rotation, especially when the knee joint is almost fully extended.
   
5. The PCL restricts posterior tibial dislocation.
   
6. The PCL is important in stabilizing the knee joint during backward movements, such as landing from jumping or climbing down stairs.

Common Injuries

Injuries to the cruciate ligaments are common, especially in athletes and weightlifters; however

ACL injuries are more common than ACL injuries.

1.      Anterior Cruciate Ligament (ACL) Injuries (3,4,5)

• ACL sprain or tear is very common.
• These injuries occur as a result of the following causes:
• Sudden changes in the direction of motion, stopping abruptly, or slowing down while running.
• Abnormal landing from jumping.
• Direct blow to the knee.
• Common symptoms include:
• Popping sound at the moment of injury.
• Deep knee pain.
• Swelling due to haemarthrosis.
• Instability in the knee joint as a “giving away” feeling.
• Reduced motion ability.

2.      Posterior Cruciate Ligament (PCL) Injuries (6)

• PCL tears are usually accompanied by other ligament injuries, and isolated PCL tears are even less common.
• PCL injuries are less severe than ACL injuries.
• These injuries can occur due to high-impact trauma, such as accidents or falls.
• Common symptoms:
• Mild to severe pain.
• Swelling and stiffness.
• Instability in the knee.
• Reduced motion.

Treatment Approaches

Treatment of ACL and PCL injuries depends on the severity of the injury. They can be a combination of management of rest, medications to relieve pain, and physical therapy. In severe cases, more potent drugs can be prescribed, and surgical interventions may be necessary to repair the damaged ligament, particularly in ACL injuries.

References

1. https://fixknee.com/acl-anatomy#:~:text=The%20anterior%20cruciate%20ligament%20(ACL,the%20center%20of%20the%20knee.
2. https://www.kenhub.com/en/library/anatomy/anterior-cruciate-ligament
3. https://www.ncbi.nlm.nih.gov/books/NBK499848/
4. https://www.mayoclinic.org/diseases-conditions/acl-injury/symptoms-causes/syc-20350738
5. https://orthoinfo.aaos.org/en/diseases–conditions/anterior-cruciate-ligament-acl-injuries/
6. https://my.clevelandclinic.org/health/diseases/21793-pcl-posterior-cruciate-ligament-tears

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