Cruciate ligament tears can be classified according to location and severity:

1. Partial cruciate ligament tears: Partial injury of the ligament, where residual stability is maintained.
2. Complete cruciate ligament tears: Complete severance of the ligament, leading to instability.
3. Anterior cruciate ligament tears (ACL): Most common form, typically caused by sudden stops or twisting movements.
4. Posterior cruciate ligament tears (PCL): Less common, usually due to direct impact on the bent knee.

The main causes of cruciate ligament tears can be divided into different categories:

- **Sports activities:**

- Sudden stops, rotational movements, or landings after jumps, as seen in sports like soccer, basketball, or skiing.

- **Traumatic events:**

- Falls or direct impacts, for example, in traffic accidents.

- **Biomechanical misalignments:**

- Instability or misalignments in the knee joint increase the risk of injuries.

- **Previous knee injuries:**

- Existing damage or weaknesses in the knee joint can promote cruciate ligament tears.

The symptoms vary depending on the severity of the injury, but often include:

• Sudden pain: Intense pain in the knee, often accompanied by an audible "pop."
• Swelling: Rapid onset of swelling due to bruising in the joint (hemarthrosis).
• Instability: Feeling of "giving way" or insecurity when walking or standing.
• Movement restrictions: Difficulty bending or straightening the knee joint.
• Muscle weakness: Decrease in muscle strength in the thigh due to protective posture.

The diagnosis is made through a combination of medical history, clinical examination, and imaging techniques:

• Medical History:
  • The doctor inquires about the accident mechanism, typical symptoms, and daily life limitations.
• Clinical Examination:
  • Tests such as the Lachman test or the pivot-shift test assess the stability of the cruciate ligament.
• Imaging Techniques:
  • MRI: High-resolution imaging of the ligament and possible accompanying injuries such as meniscus tears.
  • X-ray: Exclusion of bone injuries or fractures.
  • Ultrasound: Assessment of joint effusions or other soft tissue damage.

Conservative Therapy

For partial tears or low daily stress, conservative treatment may be sufficient:

• Physiotherapy:
  • Exercises to stabilize and strengthen the surrounding muscles.
• Pain Therapy:
  • NSAIDs to relieve pain and inflammation.
• Orthoses:
  • Use of knee braces or splints to stabilize the joint.

Surgical Therapy

For complete tears or high athletic demands, surgery is often necessary:

• Cruciate Ligament Reconstruction:
  • Replacement of the torn ligament with the body's own tendon material, e.g., from the patellar tendon or hamstring tendon.
• Arthroscopy:
  • Minimally invasive surgery to remove damaged tissue and prepare for ligament replacement.
• Suturing Techniques:
  • For fresh tears, an attempt is made to reconstruct the ligament with special sutures.

To prevent cruciate ligament tears, the following measures are recommended:

1. Strengthening the muscles: Regular training of the thigh and calf muscles to stabilize the knee joint.
2. Coordination training: Exercises to improve movement sequences and proprioception.
3. Proper footwear: Use of sports shoes with sufficient cushioning and support.
4. Warming up before sports: Preparing the body with targeted mobilization and stretching exercises.
5. Avoiding overstrain: Sufficient breaks between intense training sessions.