About Knee Ligaments
As one of four ligaments in the knee joint, the anterior cruciate ligament (ACL) attaches the tibia, one of two bones in the shin, through the knee joint to the distal or lower head of the femur, or long bone of the thigh. Injury to this ligament is one of the most common to individuals involved in sports. The ligament is extremely important in knee joint stability and can be damaged through fast changes in direction as well as pivoting or twisting movements, as is common in many sports.

A torn or ruptured anterior cruciate ligament may be diagnosed through physical examination, x-rays and an MRI scan. In some cases, damage to the anterior cruciate ligament requires surgery.  Repair of the anterior cruciate ligament maybe performed on an outpatient basis.

The posterior cruciate ligament (PCL) is also found at the knee joint, located directly behind the anterior cruciate ligament.  The posterior cruciate ligament is responsible for keeping the tibia or shinbone in place.

The medial collateral ligament (MCL) is also one of the four major ligaments that promote knee joint stability.  While the less common injury than posterior or anterior cruciate ligament tears, medial collateral ligament injuries are commonly found in football-type injuries, such as when the knee joint is struck from the outside.

Knee Ligament Repair Procedures
Repair of a torn anterior cruciate ligament is performed on an outpatient basis, enabling patients to engage in the surgery in the morning and be home later that afternoon. Surgical repairs of the ACL and PCL is often performed with an arthroscope, a thin, flexible fiberoptic scope about the diameter of a drinking straw introduced in a very small (about 1/8 inch) incision in the knee joint.
 
Reconstruction of the posterior cruciate ligament depends on the severity of the injury.  Injuries to the PCL are graded:

• Grade I: partial tear of the posterior cruciate ligament
• Grade II: complete or isolated tear to the posterior cruciate ligament
• Grade III: torn posterior cruciate ligament in addition to injury to additional or surrounding ligaments

In most cases, surgery is not a necessary aspect of MCL treatment plans. Treatment for medial collateral ligament repair and healing rely on strengthening the knee joint, allowing pain and swelling to subside, and increasing range of motion and strengthening exercises through physical therapy. If surgery is required, it generally follows the same process as that engaged during an ACL or PCL repair procedure.

Knee ligament repair procedures are performed through a laparoscopic or arthroscopic assisted technique, also known as a traditional surgical technique called open ACL/PCL/MCL repair or reconstruction. Many ligament repairs performed using the laparoscopic approach may be performed on an outpatient basis.

Such procedures are performed with an arthroscope, a very thin, flexible fiberoptic scope about the diameter of a common drinking straw introduced in a very small (about 1/8 inch) incision in the knee joint. A camera attached to the end of the arthroscope enables the surgeon to view the surgical field without the major tissue damage. During ligament reconstruction surgeries, the surgeon may also harvest a portion of the patellar tendon to use for repair or replacement of the torn or damaged anterior and posterior cruciate ligaments or the medial collateral ligament. The graft is held in place with metallic or bioabsorbable screws.

How Much Does Knee Joint Ligament Repair Cost?
Knee ligament repair procedures often average around $3,000 using arthroscopy, but hospital costs, surgeon's fees and anesthesiologist fees and physical therapy costs add up, leaving many individuals, depending on medical coverage, paying between $10,000 to $30,000 for the procedure in the United States. The same surgical procedure and treatment in India may average $3,500, while medical patients traveling to Mexico or Costa Rica may pay $4,300 to $9,400, depending on the severity of the ligament damage and procedure chosen by the surgeon.

Who Performs ACL/PCL/MCL Repairs?
Orthopedic surgeons must pass board certification following oral and written examinations in their native or adoptive countries of origin. In the United States, this is the American Orthopedic Association, the American Academy of Orthopedic Surgeons or the American Board of Medical Specialties.

Some orthopedists sub-specialize in fields such as sports or trauma medicine, while others specialize in the treatment of arthritis, spinal cord or congenital defect diseases or conditions. Check the credentials of any physician or surgeon through a State, Provincial or National Board of Orthopedic Surgeons to find information about any particular physician, surgeon or specialist in various orthopedic treatment and surgical fields.