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The unhappy triad, also known as the terrible triad, is a combination of a torn ACL, torn meniscus, and torn MCL. Since there are three injuries, that all cause major problems in the knee, the combination of injuries came to be known as the unhappy triad by many doctors and patients.
The anterior crucial ligament, meniscus, and medial crucial ligament are the three ligaments and tendons that are injured in the unhappy triad. They can be either partially or fully torn. This specific combination of injuries, since there are three is known as the unhappy triad, or also referred to as the O’Donaghue triad after one of the doctors who worked on it.
Since a torn ACL is the most difficult injury to treat and requires surgery and lengthy recovery time, it is commonly thought of as the worst of the three injuries. After that the meniscus tear is the next most serious injury since many times it also requires surgery to be repaired. Finally, the MCL tear is normally the least troublesome injury since it often can heal on its own.
Unfortunately in most cases, surgery is required to repair injuries in the unhappy triad. Since the ACL and meniscus cannot generally heal on its own, surgery is normally the only solution to fix this knee injury. The recovery time is normally between 6-9 months to regain full use of the knee and return to normal activities.
The most common symptoms of the unhappy triad are pain, swelling, and difficulty moving or straightening the knee. There is also many times bruising that can happen on the knee and sometimes on the bone depending on the strength of the impact that caused the injury. Most patients also describe a popping or clicking noise at the time of injury.
The unhappy triad is almost always treated with surgery to repair the multiple tears that happen in the knee. Physical therapy and rest to allow the knee and the tendons to fully recover and gain back a full range of motion normally follow this.
The recovery time for most unhappy triad injuries is between 6-9 months until full range of motion returns and the patient can again participate in physical activity and sports. The long recovery time is mostly due to the ACL reconstruction that is often necessary for complete recovery. Physical therapy is also normally part of the treatment process.
Yes! If you think you may have torn the ACL, MCL, and/or meniscus in your knee it is essential that you see a doctor. The injury will not heal on its own and likely will become worse if you do not see a doctor and get treatment.
Contact sports are the most common sports where athletes suffer from unhappy triad injuries. Most often football, rugby, hockey, and soccer are the top sports that report this type of injury. Skiing, snowboarding, and some other snow sports can also lead to an unhappy triad injury. Finally, as extreme sports like skateboarding and motocross become more popular, those athletes also may suffer from this injury.
When you go to the doctor to have your knee injury examined, you can expect the doctor to perform a physical exam where they touch y our knee, observe the swelling and pain, and perform range of motion and other tests to determine the injury. This is usually followed up with an MRI and sometimes an ultrasound or x-ray as well.