What is The "Unhappy Triad"?
unhappy triad is a common combination of three different injuries
in the knee, and they often all occur together. The ACL tear, meniscus
tear, and MCL tear make up this terrible triad, and can definitely
ruin your day.
Whoever said that bad things happen in threes was
unfortunately right. Here's what you need to know about this sports
The worst part of
unhappy triad, the torn acl
is the most significant
of the three
injuries. It requires surgery to fix, and can take
months to a year to recover from.
Injury to the
ACL leaves your knee
unstable, often to simple straight forward walking. Without the ACL,
your knee looses its ability to maintain normal function, and you
experience episodes of giving way or buckling.
second part of the triad. The meniscus is fibrocartilage within the
knee joint that helps to provide cushion and reduce friction and
stresses on your bones.
It is very commonly
injured during athletic
activity, and with an ACL tear.
generally have to be
treated surgically, because the meniscus does not have very good blood
supply, and is very slow to heal. If left untreated, it produces pain,
swelling, and popping or catching sensations in your knee.
The MCL tear
The medial collateral ligament runs along the inside of the knee, and
helps to provide stability to the knee joint. Injury to this ligament
makes up the thrid part of the triad. Injury to the MCL is
significant, however, out of the three, it is the least problematic,
and does not require surgery. Medial collateral ligament injury
produces pain, some instability, decreased range of motion, and
How It Happens
The Unhappy triad occurs most with contact injuries from football,
rugby, and other high impact sports. It takes a significant amount of
force to injure all three structures at the same time.
and meniscus tears can occur with non-contact mechanisms such as a
plant and turn, MCL injury requires some type of lateral blow
fall. So it is not as common among
A blow to the outside of
your knee, like from a tackle, can cause this combination of injuries
to occur. This places a
great amount of stress on your knee and the ligaments, specifically the
ACL and MCL.
As your knee continues along this
path of stress, your ACL
often tears, causing the knee to shift. As the knee shifts, your femur
and tibia compress against the meniscus, and this causes tearing of the
cartilage. And then, because of the position of your knee, the MCL will
tear as well...not a pretty picture.
Unfortunately, treatment for the unhappy triad requires surgery.
Reconstruction of the ACL
primary focus, and the damage to the
meniscus is taken care of during this procedure. The MCL needs time and
immobilization to heal correctly, and this can occur after the
ACL surgery. Many times your surgeon may have you wait several weeks
before ACL reconstruction to reduce swelling and improve your
motion...this will also allow the MCL tear to begin to heal.
The unhappy triad is a combination of an ACL tear, meniscus tear, and
MCL tear, and usually occurs during contact sports. It
requires surgical intervention, and rehabilitation following surgery.
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