Knee Ligament Reconstruction

Comprehensive Care for Complex Knee Instability

Beyond the ACL and PCL, the knee relies on the medial collateral ligament (MCL), lateral collateral ligament (LCL), and posterolateral corner (PLC) structures for side-to-side and rotational stability. Injuries to these ligaments range from simple sprains that heal well without surgery to complex, multi-ligament injuries that require careful surgical reconstruction.

Dr Adam Farrier is a consultant knee surgeon offering knee ligament reconstruction, including MCL, LCL, posterolateral corner and multi-ligament surgery, for patients in Carlisle and across Cumbria, including West Cumberland (Whitehaven), and in Newcastle upon Tyne and the North East.

Is Surgery Right for You?

The majority of isolated MCL injuries heal well with bracing and rehabilitation alone. Surgery is generally reserved for LCL and posterolateral corner injuries, which tend to heal poorly without intervention, for high-grade MCL tears that fail to settle, or for complex injuries involving multiple ligaments at once - often the result of high-energy sporting or traumatic injuries.

The Procedure

Depending on which structures are involved, surgery may involve repairing the ligament directly or reconstructing it with a tendon graft, restoring the knee's normal restraints against side-to-side and rotational forces. In multi-ligament injuries, reconstruction of several structures is often required in a single, carefully planned operation to restore overall knee stability.

The Benefits of Reconstruction

• Restoring Side-to-Side Stability: Reconstruction addresses the wobbling or giving-way sensation caused by collateral ligament insufficiency.

• Correcting Rotational Instability: Posterolateral corner reconstruction in particular addresses a specific pattern of rotational instability that can otherwise jeopardise the success of any ACL or PCL surgery performed alongside it.

• Protecting Other Ligament Reconstructions: Addressing peripheral ligament instability protects the longevity of any combined ACL or PCL reconstruction.

• A Coordinated Approach to Complex Injuries: For multi-ligament knee injuries, a single well-planned reconstruction avoids the compounding risks of staged, repeated surgeries.

Important Considerations & Risks

• Complexity of Multi-Ligament Surgery: These are technically demanding procedures, generally reserved for more complex injury patterns, and carry a longer and more involved recovery than single-ligament surgery.

• Nerve Involvement: Posterolateral corner and LCL injuries can occasionally involve the nearby peroneal nerve, which will be carefully assessed both before and after surgery.

• Extended Rehabilitation: Recovery from combined ligament reconstruction is a longer process than single-ligament surgery and requires sustained commitment to physiotherapy.

Frequently Asked Questions

How do I know which ligaments are injured?

A thorough clinical examination combined with MRI imaging accurately identifies which structures are involved, which is essential for planning the right treatment approach.

Will I need more than one operation?

Where possible, multiple injured structures are addressed in a single operation to give the best overall outcome and avoid the added risks of repeated surgery.

How long is recovery after multi-ligament surgery?

Recovery is longer than for isolated ACL or PCL surgery, often 12 months or more, reflecting the complexity of restoring multiple stabilising structures around the knee.

Dr Farrier's Note

"Complex ligament injuries need a considered, individualised plan rather than a one-size-fits-all approach. I take the time to fully understand each patient's injury pattern before recommending a course of treatment."