Cruciate ligament surgery is necessary if a torn cruciate ligament cannot be adequately treated with conservative therapy measures.
Here you will find the most important information and qualified cruciate ligament surgery specialists.
On the inside and outside of the knee joint, collateral ligaments interact with the muscles to support the joint capsule and prevent the knee from pushing through too much. Inside the joint cavity are two cruciate ligaments that stabilize the knee.
The anterior cruciate ligament prevents the lower leg from sliding too far forward. When the knee is bent, the posterior cruciate ligament tightens so that the lower leg does not slide backwards. The video shows the structure of the knee joint with its bones, ligaments and cartilage:
Although the cruciate ligaments have a high tensile strength and are extremely elastic, they can tear after great force is applied to the knee joint (e.g. in traffic accidents), due to excessive bending or stretching or a sudden change of direction (e.g. during sport). Doctors then speak of a cruciate ligament rupture.
The affected cruciate ligament can tear or tear completely. Depending on which cruciate ligament is torn, it is either an anterior or posterior cruciate ligament tear. In nine out of ten cases, the anterior cruciate ligament tears.
In the case of serious knee injuries, both cruciate ligaments can also tear - for example, if the knee joint isdislocated (luxated) due to an impact during an accident.
© Henrie / Fotolia
If the knee hurts and swells, this may indicate a cruciate ligament rupture. As the cruciate ligaments stabilize the knee, the knee is unstable after a cruciate ligament rupture. Symptoms of this are
You may also feel that you can no longer bend or straighten your knee.
Anyone suffering from one or more of these symptoms should consult an orthopaedist, who can diagnose a cruciate ligament rupture on the basis of the description of the accident, a palpation examination and various movement tests (drawer test, Lachmann test, rotational slip test).
An absolutely reliable diagnosis is provided by magnetic resonance imaging (MRI), which can be used to visualize a torn cruciate ligament.
By cruciate ligament guru - Own work, CC-BY-SA 4.0, Link
Once a cruciate ligament rupture has been diagnosed, it must be clarified how it can be optimally treated. Conservative treatment methods to stabilize the knee include
If the posterior cruciate ligament is torn, those affected often feel less impaired and it may be possible to stabilize the knee sufficiently without surgery.
Conservative treatment is alsoadvisable for patients who are not active in sports or for whom an operation (due to their advanced age, for example) entails major risks.
Whether cruciate ligament surgery is indicated as part of knee surgery must be decided on an individual basis. The fact is that a cruciate ligament rupture does not heal by itself.
Decision criteria for or against cruciate ligament surgery include
If the cruciate ligament tear is accompanied by other injuries to the knee joint (e.g. a splinter has been torn from the bone, lateral tendons have been torn or the meniscus has been injured), cruciate ligament surgery is unavoidable.
Without surgery, the knee is at risk of remaining unstable. In addition, painful osteoarthritis can develop in the knee as a late consequence. If the anterior cruciate ligament is torn, younger and athletically active patients benefit from an operation.
If a patient's range of movement is significantly restricted by the cruciate ligament tear, if they can hardly bear any weight and/or if persistent pain is affecting their life, then they should talk to their doctor about cruciate ligament tear surgery.
Conventional open surgery involves a longer incision on the front of the knee, which exposes the entire knee joint.
Alternatively, cruciate ligament surgery can be performed usingarthroscopy, which only requires two or three tiny incisions. This operation is much less invasive.
Depending on the degree of injury, there are different methods of restoring the function of a torn cruciate ligament.
The video shows the procedure for this minimally invasive operation :
An inserted plastic ligament can only replace the torn cruciate ligament in exceptional cases - for example, after multiple failed operations or in older patients whose tendons are no longer elastic. Instead, the plastic ligament is intended to stabilize the injured cruciate ligament until it has healed.
Open knee surgery - By Uwe Gille - Own work, CC BY-SA 3.0, Link
Cruciate ligament surgery is usually performed under general anesthesia - sometimes combined with local anesthesia of the knee - and takes between one and one and a half hours on average.
Complications in the course of cruciate ligament rupture surgery are rare. If minimally invasive surgery is used, fewer "after-effects" and a shorter period of time until full recovery can be expected.
Post-operative pain can be successfully treated with painkillers. The prophylactic administration of blood-thinning medication in the first few days after the operation prevents thrombosis. Certain surgical risks and complications cannot be completely ruled out even with cruciate ligament surgery.
After cruciate ligament surgery, the knee must not be fully loaded immediately, which is why walking sticks are used for the first two to three weeks to relieve the affected leg.
Wearing a knee brace is recommended for six to 12 weeks after the operation. To ensure that the knee can bear weight as quickly as possible and regain its full range of motion, patients should make use of professional physiotherapy and physiotherapy. The therapy plan is tailored to the individual healing process.
© Picture-Factory / Fotolia
If rehabilitation is optimal, the knee joint will be stable and mobile again after around six to nine months. Apart from competitive athletes, patients should not take part in high-risk sports that put a lot of strain on the knee in the first year after the operation.
The prognosis is favorable: eight out of ten patients achieve the same level of performance after cruciate ligament surgery as they had before their injury.
Surgery on the human musculoskeletal system is performed by specialists in orthopaedics and trauma surgery. They often specialize further, for example exclusively in knee surgery or sports surgery.
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