Anterior cruciate ligament reconstruction
Content
Description
The proper function of the knee depends not only on the joint surfaces, but also on the knee ligaments.
The stability of the knee is mainly ensured by the anterior cruciate ligament (ACL), which - however - is very often damaged during injuries:
- Improper landing after a jump.
- During excessive rotational and dynamic movements typical of skiing, football, soccer, hockey, basketball, volleyball, squash.
Facts
- General anesthesia or sedation
- One-day surgery
- Procedure lasts up to 2 hours
- Recovery after 6 - 12 months
The injury itself causes immediate pain and restriction of movement, it is possible to hear how the ligament ruptures.
For a correct diagnosis, an examination by an orthopedist and the use of MRI (magnetic resonance imaging) is necessary.
- A partially torn ligament usually heals spontaneously without the need for surgery within 2 - 3 months (treatment, rehabilitation, sometimes a knee brace is necessary).
- A major injury means a complete rupture of the ligament, often the meniscus is also damaged.
If surgery is required, treatment begins with preoperative rehabilitation. It is important to train the stiff knee and regain strength (rehabilitation takes about 3 weeks). The aim of the surgery is to reconstruct the knee ligament, several types of surgery are used:
- Patellar tendon method - the ligament is replaced using part of the tendon, which is located under the patella and is also removed with part of the bone (bone blocks). This graft is inserted in place of the damaged ligament.
- Hamstring method - tendon grafts are taken from the thigh muscles (called hamstrings) and inserted to replace the damaged ligament.
- Quadriceps method - a tendon graft is taken from the tendon of the hamstring muscle.
- Allograft method - donor grafts can also be used for ligament reconstruction.
The knee must be spared postoperatively and a return to sporting activities is possible after 6 - 12 months. If a graft is used for reconstruction, it begins to heal after 4 weeks and it is weakest after 6 - 8 weeks after surgery.
- Early phase of rehabilitation (up to week 9)
Rehabilitation focuses on increasing the knee's range of motion (knee flexion-extension), reducing pain and swelling. It is important to avoid improper loading of the knee, as there is a risk of tearing the graft.
- Intermediate phase of rehabilitation (weeks 9 - 16)
The graft used for reconstruction is stronger, so the load and exercises that strengthen the limb are gradually increased during exercise.
- Late stage of rehabilitation (weeks 16 - 24)
It is possible to start to fully load the limb, including jumps, rebounds and improving coordination.
