Ligaments are fibrous tissue that connect bone to bone.
In the knee there are 4 principal ligaments; ACL(anterior cruciate ligament), PCL(posterior cruciate ligament),MCL(medial collateral ligament) and LCL(lateral collateral ligament).
Ligaments in the knee provide structural stability for the joint. If a ligament is injured, partially torn or stretched it affects the stability of the joint. Instability often results in very small movements, mircomotion, within the joint that is outside the range of normal. Micro-motion places additional forces and stress on the joint which translates to abnormal wear and tear on the joint. Patients typically complain of instability, pain and swelling.
PR is a 40 y/o minor league baseball player who presented to the Centeno-Schultz Clinic with 10 plus year history of right knee pain who underwent multiple therapies including PT, massage, chiropractic care, Synvisc injections. Two arthroscopic surgeries failed to provide a reduction in pain. On physical examination his anterior cruciate ligament was noted be loose. Not loose enough to require surgery but loose enough to create excessive wear and tear on the knee with resultant pain and swelling.
At the Centeno-Schultz Clinic, PR underwent two x-ray guided injections of prolotherapy directly into the ACL. After the needle is placed into the ACL a small amount of contrast is injected which outlines the ligament. This is shown below. After two proloterapy sessions PR has had near complete resolution of his chronic knee swelling and 75% reduction in pain. Structure stability is essential in evaluating all joints and is the standard of care at the Centeno-Schultz Clinic.