Video transcript
Let’s go over your knee injury and what to expect during recovery.
You’ve sustained a soft tissue injury to the knee. This might involve one of the ligaments — such as the ACL, PCL, MCL or LCL — the meniscus, or the cartilage and underlying bone, known as an osteochondral surface. These structures help stabilise the knee and absorb force during movement.
Injuries like this usually happen from twisting, impact, or hyperextension — often during sports, a fall, or other trauma. You might notice swelling, pain, a feeling of instability, limited movement, or mechanical symptoms like locking or clicking.
These injuries can be difficult to fully assess in the Emergency Department. Swelling and pain may mask signs of instability, and X-rays are mainly used to rule out fractures. If there’s no broken bone, you’ll be sent home with early support — usually a splint and crutches — and referred to the fracture clinic for a proper assessment.
You’ll normally be reviewed in the fracture clinic about a week after the injury. This delay is intentional — it gives swelling and pain time to settle so we can perform a more accurate examination. At that appointment, your knee will be gently examined to test for ligament instability or meniscal damage. This involves carefully moving the knee to check whether any of the supporting structures have been stretched or torn.
If we don’t find signs of significant injury, you’ll be discharged with advice to gradually reduce your use of the splint and crutches. Most of these injuries improve over six to eight weeks with simple rehabilitation. We don’t routinely follow these cases, but if your symptoms don’t improve or get worse, you can contact the outpatient team to arrange a re-review. Persistent symptoms might be the only clue that there’s a deeper injury.
If your examination or imaging raises concern for a more serious problem, we may refer you for an MRI scan. MRI allows us to see soft tissue injuries that don’t show on X-rays. Your scan may be booked anywhere from one to six weeks after your appointment, depending on urgency and scanner availability. Please remove any piercings before your scan, and let us know if you have any implanted metal devices like pacemakers, insulin pumps, or nerve stimulators.
While waiting for your MRI, you should keep using the splint and crutches as needed. You can put weight on the leg as pain allows. If things start to improve, you can gradually reduce support. Walking on flat ground is fine, but avoid sports, high-impact activity or heavy lifting until we’ve completed your assessment.
Once your MRI is done, it will be reviewed by a radiologist — this may take another week or two. Once the report is ready, we’ll bring you back to clinic to go through the results and plan next steps. If you let us know when the scan is complete, we can track your report and arrange your follow-up promptly. If you come to clinic before the report is available, we may not be able to give you final answers on treatment.
In older patients, MRI scans sometimes show early wear and tear, like degenerative meniscal tears. If that happens, we’ll explain what’s been found. However, these degenerative issues are usually managed by your GP and referred onwards to the elective knee clinic if needed.
Treatment depends on which structure is injured and how severe the damage is. Partial ligament sprains and minor meniscal injuries are often treated without surgery, using physiotherapy to restore strength, control, and range of motion.
ACL and meniscal injuries usually start with non-operative management. If your symptoms improve, no surgery is needed. But if you have ongoing instability, locking, or pain, surgery may be discussed later — especially if you're active or play pivoting sports. PCL, MCL and LCL injuries are even more likely to be managed without surgery, depending on severity and which other structures are involved.
Cartilage and bone injuries — called osteochondral defects — can vary. Some heal with modified activity and rehab, while others may need specialist input if the area is large or causing symptoms.
If your case is more complex or unclear, we may book you into a clinic where a knee specialist is present. If the specialist is unavailable due to leave or emergency cover, we may reschedule your appointment to make sure you're seen by the right person.
After your Emergency Department visit, you’ll be fitted with a splint and referred to the fracture clinic after one week. There, your knee will be examined. If we’re not concerned about a major injury, you’ll be discharged with advice on gradually stopping the splint and crutches.
Most of these injuries settle over six to eight weeks, and you’re welcome to contact us again if your symptoms don’t improve.
If further investigation is needed, we’ll arrange an MRI. Once your scan is done and the report is available, we’ll bring you back to clinic. Please notify us when your scan is complete so we can monitor your results and arrange the follow-up.
Most soft tissue knee injuries improve with time, weightbearing as tolerated, and structured physiotherapy. Surgery is reserved for selected cases — particularly if symptoms persist or if there’s ongoing instability or mechanical problems like locking. Your treatment will be based on your specific injury and your functional goals.