PROF. DR. SAMMY HANNAMD · FACS · FRCS (TR&ORTH) · CCT (TR&ORTH)
KNEE LIGAMENT INJURIES & INSTABILITY · ABU DHABI
The ACL, PCL, MCL, LCL and posterolateral structures each contribute to knee stability in different directions. Assessment connects the injury mechanism, pain location, swelling, giving-way pattern and a structured ligament examination with the person’s work, sport and confidence in the knee. Knee ligament surgery in Abu Dhabi is performed at Healthpoint Hospital.
CHAPTER 01 · THE PATTERN
Choose the description closest to the injury or instability. The pattern helps organise the ligament examination; symptoms alone cannot identify which structure is injured.
This mechanism commonly stresses the medial side of the knee and can injure the MCL. The examination still checks cruciate and other structures because higher-energy contact may involve more than one ligament.
See what the examination checks →CHAPTER 02 · EXAMINATION
A structured examination compares front-to-back, side-to-side and rotational stability with the opposite knee. Tenderness, swelling, range of motion and neurovascular status help distinguish an isolated ligament injury from a more complex pattern.
A direct blow, pivot, hyperextension, bent-knee impact or dislocation pattern immediately narrows which stabilising structures require focused testing.
Ligament-specific tests assess the direction and degree of abnormal movement rather than treating all giving way as the same problem.
The ACL, PCL, MCL, LCL and posterolateral structures are checked together because one injured ligament can coexist with several others.
High-energy or multi-ligament injuries can threaten the popliteal vessels or peroneal nerve, so circulation and neurological function must be assessed.
Daily walking, manual work, contact sport and pivoting competition place very different demands on residual stability and influence treatment decisions.
“The direction of laxity helps identify which stability system is failing.”
CHAPTER 03 · LIGAMENTS & IMAGING
The ACL and PCL control important front-to-back and rotational movements; the MCL and LCL resist excessive side-to-side opening; the posterolateral corner is a region of several structures contributing to lateral and rotational stability. X-rays and MRI are selected according to the injury pattern and the clinical question.
SELECTED OBSERVATION 01 / 03
Surgery becomes more relevant when instability is high-grade or persistent, when several ligaments are injured, when the person requires reliable stability for sport or work, or when associated injury changes the balance. The exact operation depends on which structures are damaged.
Not simply because the MRI says “ACL tear.” Reconstruction becomes more relevant when the knee remains functionally unstable, the person needs reliable pivoting or cutting for sport or work, or associated injuries make surgical stabilisation more appropriate.
The plan distinguishes ACL, PCL, MCL, LCL and posterolateral injury rather than treating “instability” as one diagnosis.
Giving way, shifting or inability to trust the knee continues to limit the activities that matter after an appropriate rehabilitation attempt.
Multi-ligament patterns, knee dislocation and associated meniscus, cartilage, nerve or blood-vessel injury can change urgency and surgical planning.
Whether treated non-operatively or surgically, regaining motion, strength, neuromuscular control and confidence requires structured rehabilitation.
IF THE NEXT QUESTION BECOMES MORE SPECIFIC
These routes separate isolated ACL problems, arthroscopic procedures and the later return-to-sport decision.
THE RECOVERY THAT MATTERS
Rehabilitation rebuilds motion, strength, balance and neuromuscular control, then progressively challenges the knee with direction change, perturbation and task-specific loading. Confidence grows when the knee repeatedly responds without giving way.
RELATED CLINICAL ROUTES
Use these routes when the dominant issue is an ACL tear, associated meniscus injury, cartilage damage or the broader sports-knee pathway.
KNEE LIGAMENT INSTABILITY FAQ
General information only. The diagnosis and treatment of ligament injuries depend on the injury mechanism, examination, imaging when indicated, activity demands and whether one or several structures are involved.
Request an appointmentIt may feel like giving way, shifting or loss of confidence during turning, uneven ground or sport. The exact sensation does not identify the injured ligament by itself.
The ACL, PCL, MCL, LCL and posterolateral stabilising structures all contribute to stability. Some injuries affect one ligament and others involve several structures together.
No. Many isolated MCL injuries are managed without surgery using protection and rehabilitation. Surgery may be considered for selected severe, chronic or combined injuries.
The mechanism, posterior stability testing, range of motion and associated injuries are considered together. MRI or other imaging may be used when it will change management.
They can create instability in several directions and may be associated with knee dislocation, meniscal or cartilage injury, or nerve and blood-vessel injury. The assessment is therefore broader and sometimes more urgent.
Rehabilitation can restore motion, strength, balance and neuromuscular control and is central to many ligament injuries. Whether it is enough depends on the injured structures, residual instability and activity demands.
Surgery may be discussed for persistent or high-grade instability, some combined injuries, or when reliable stability is needed for higher-demand sport or work and non-operative management is unlikely to meet those goals.
DEFINE THE INSTABILITY
Bring details of the original injury, where the pain is felt, episodes of giving way, previous rehabilitation, imaging if available and the activities you need to return to. The consultation can then define which ligament system is involved and whether the best route is protection, rehabilitation, bracing, surgery or assessment of associated injury.
YOUR SPECIALIST
Prof. Hanna is a UK board-certified consultant orthopaedic hip and knee surgeon at Healthpoint Hospital, Abu Dhabi. His clinical interests include sports and soft-tissue knee problems, cruciate ligament injuries, arthroscopic surgery, knee cartilage and meniscus problems, partial knee replacement, primary and revision joint replacement, minimally invasive techniques and robotic-assisted hip and knee replacement.