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Oxford University Hospitals NHS Foundation Trust
Hip and Knee

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Ligament injuries

Anterior cruciate ligament injury

The anterior cruciate ligament (ACL) crosses from the back of the femur to the front of the tibia in the middle of the knee. It controls forward movement and rotation of the knee joint. It is essential for side stepping, pivoting and landing from a jump.

The ACL is commonly injured while playing pivoting sports, particularly ball sports such as football, rugby, basketball and netball. Skiing, car accidents and farming are other common causes of ACL injury.

For further information, please download the booklet below:

Posterior cruciate ligament injury

The posterior cruciate ligament (PCL) crosses from the front of the thigh bone (femur) to the back of the top of the shin bone (tibia) in the middle of the knee. It prevents the tibia sliding back from the femur.

The PCL is commonly injured by a direct blow to the front of the leg in motorbike, motor vehicle or pedestrian accidents. It may be injured during sport, particularly when landing on a bent knee.

The majority of patients with PCL injuries can be well managed without the need for surgery.

Medial collateral ligament injury

The medial collateral ligament (MCL) links the thigh bone to the shin bone on the inner aspect of the knee.

The MCL may be completely or partially torn by an outside blow to your knee that causes it to stretch beyond its normal range of motion. In a MCL tear the ACL and meniscus may also be torn at the same time. This is a common injury caused by tackling during rugby.

MCL injuries can normally be treated without surgery. If it occurs in combination with an ACL injury, the MCL is usually treated by a period in a protective brace; once this is healed the knee is rehabilitated prior to reconstructing the ACL.