REMINDER FOR THE PATIENT IF AN ACL RUPTURE IS SUSPECTED
- It is strictly forbidden to put weight on the injured leg and try to “diverge”. it's so easy to make the problem worse.
- Even if the pain is not severe, you need to immobilize the joint: apply a bandage or plaster, and do not step on the sore leg when walking.
- Apply cold.
- Seek advice from a traumatologist, even if the injury seems minor.
Old knee injuries left without treatment will definitely remind you of themselves: the knee will hurt, react to the weather, osteoarthritis may develop - in advanced cases this is an indication for prosthetics. If ignored, surgery will eventually be required to repair the joint. Surgery is not the best treatment: the recovery process may take six months, but the knee after ligament replacement will never be as mobile and resilient as a healthy one. Therefore, if you have any damage, pain, or instability after an injury, contact a traumatologist. The Doctor Ost MC presents modern methods for restoring the ACL after a rupture.
Anterior cruciate ligament rupture
A torn anterior cruciate ligament is a serious injury that very often occurs during sports. Rupture of the cruciate ligament leads to pathological excessive mobility and collision of the two articulating surfaces of the knee joint. Over time, this causes the destruction of articular cartilage and the development of deforming arthrosis. If at the time of injury you feel severe pain in your knee, up to a second loss of consciousness, and subsequently the stability of the joint is impaired, contact an orthopedic traumatologist in a timely manner.
- Our specialists
At the Ilyinskaya Hospital, patients with anterior cruciate ligament rupture are assisted by Dr. Alexander Neverkovich
, an orthopedist specializing in arthroscopy, pathologies and injuries of muscles and ligaments in athletes and people actively involved in sports, implantation of ligaments and muscles, meniscus transplantation. Candidate of Medical Sciences, Associate Professor of the Department of Sports Medicine at the Institute of Physical Education.
- Why does the anterior cruciate ligament rupture?
A rupture of the anterior cruciate ligament occurs when the body rotates excessively around the longitudinal axis with the tibia fixed. Such situations are especially typical for athletes, dancers, and stuntmen. In everyday life, a rupture of the anterior cruciate ligament can provoke a blow to the knee, a fall to the ground from a height, road traffic accidents, ultra-fast and sudden movements, inflammation of the ligaments, and degenerative changes in the connective tissue.
- Symptoms of anterior cruciate ligament rupture
The function of the anterior and posterior cruciate ligaments is to prevent excessive anteroposterior “sliding” motion of the tibia in relation to the femur. That is why, when the cruciate ligaments are torn, patients complain of instability, instability, even a lack of confidence when walking and when moving the knee joint. At the very moment of injury, severe pain occurs, up to a second loss of consciousness. At this moment, the patient often feels a crunch and clearly hears the crack of a rupture. The joint swells and loses its original shape. Movements in it are extremely difficult and very painful.
- Diagnostics
The diagnosis of anterior cruciate ligament rupture is made through an examination by a traumatologist and magnetic resonance imaging (MRI), which confirms the diagnosis. Ilyinskaya Hospital is equipped with a modern magnetic resonance imaging scanner. The MRI machine has a low-noise function and an increased tunnel width of 70 centimeters. A wide tunnel is better suited for patients who do not tolerate confined spaces and for people who are overweight. Experts from the Radiation Diagnostics Department of the Ilyinskaya Hospital have the most current, constantly updated knowledge, work closely with orthopedic traumatologists and provide them with an accurate interpretation of images. All diagnostic images are stored in the hospital's electronic system and are always available.
Knee. Anterior cruciate ligament rupture
Image source: joshya/shutterstock.com
- Surgery
If the anterior cruciate ligament ruptures, orthopedists and traumatologists at the Ilyinskaya Hospital perform arthroscopic surgery to stabilize the knee joint. The joint is not opened. Through small punctures, a thin arthroscope with a high-resolution video camera and miniature surgical instruments are inserted into its cavity. The cruciate ligament cannot be sutured. It is restored using prosthetics, thereby increasing the stability of the joint. The operation can be performed in two ways: using an artificial graft or using an autograft (the patient's own tissue). Stabilization of the joint using your own tissue is a more preferable technique, which has a beneficial effect on the long-term prognosis. Typically, the tendon of one of the lower leg muscles is used.
Stabilizing operations using an artificial ligament are now rarely performed. Even in the medium term, the joint does not respond very well to this method of stabilization. As a rule, these operations are performed on athletes who need to start (finish) the season on time. Subsequently, it is recommended to replace the artificial ligament with your own tissue, i.e. perform a repeat operation.
- Conservative treatment
In a significant percentage of cases, a torn anterior cruciate ligament requires surgical treatment to stabilize the knee joint. However, if joint stability is not lost, then conservative rehabilitation therapy can be applied followed by assessment of joint stability. Conservative treatment is mainly prescribed to patients in the older age group.
- Pain Management Service
The Ilyinskaya Hospital has implemented the concept of a “hospital without pain.” Our specialists have a full range of analgesics, including powerful opioid drugs, and high-tech instrumental techniques. The patient will not experience pain after the operation. To learn more.
- Rehabilitation
Rehabilitation for anterior cruciate ligament injuries is a multi-stage and complex process. There are two rehabilitation programs at the Ilyinskaya Hospital. The first is intended for athletes, dancers, stuntmen, that is, for patients whose professional activities are closely related to perfect control of the body. It involves increased loads and demands. The second program is designed for people leading a normal lifestyle. For each patient, specialists at the Ilyinskaya Hospital draw up an individual rehabilitation program that takes into account his capabilities and individual characteristics. Rehabilitation specialists at the Ilyinskaya Hospital, in collaboration with the operating surgeon and general practitioners, will make the recovery process as fast and efficient as possible.
ACL RUPTURE: TREATMENT
X-rays and MRIs are used for diagnosis at a discount. But the most modern way to assess the extent of damage to the knee joint is arthroscopy. This is a type of minimally invasive surgery in which the doctor not only examines the joint from the inside, but also, if necessary, carries out treatment: clears the joint of blood accumulations or reconstructs the cruciate ligament.
Orthopedists and traumatologists at Dr. Ost MC are ready to relieve acute pain and swelling without medications and quickly get you back on your feet in the literal sense of the word. We have at our disposal advanced treatment technologies that can replace surgery and prevent complications after an ACL injury. First of all, this is SVF therapy (injection of stromal vascular fraction). The medicine is prepared from adipose tissue's own stromal cells in combination with PRP. One injection has a powerful regenerative potential for speedy healing of the ACL.
Knee ligament injuries
Anatomy
Two collateral (side) ligaments are located along the lateral surfaces of the knee joint. The collateral peroneal (lateral lateral) ligament at the top strengthens the joint from the outside. At the top it is attached to the lateral condyle of the femur, at the bottom - to the head of the fibula. The tibial collateral (medial lateral) ligament, accordingly, is located along the inner surface of the joint. At the top it is attached to the inner condyle of the femur, at the bottom - to the tibia. In addition, some of its fibers are attached to the joint capsule and the internal meniscus, so injuries to the internal collateral ligament are often combined with an injury to the internal meniscus.
Damage to the lateral collateral ligament of the knee joint
The external collateral ligament is damaged less frequently than the internal one. Damage to the ligaments of the knee joint occurs when the tibia is excessively deviated inwards (for example, when the leg is twisted). The rupture is often complete and may be combined with an avulsion fracture of part of the head of the fibula.
Symptoms
The patient complains of pain in the area of injury, which intensifies when the tibia deviates inward. Movements are limited. The joint is swollen and hemarthrosis is detected. The severity of symptoms depends on the degree of damage to the knee ligaments. With a complete rupture, looseness (excessive mobility) in the joint is revealed.
Damage to the medial collateral ligament of the knee joint
The internal collateral ligament is injured more often, however, its damage is usually incomplete. The injury occurs when the tibia deviates excessively outward. This damage to the ligaments of the knee joint is often combined with a rupture of the internal meniscus and damage to the joint capsule, which can be diagnosed during an MRI of the knee joint.
Symptoms
The joint is swollen, pain is detected when palpating, moving, or deflecting the lower leg outward. Hemarthrosis is detected. Movements are limited. A complete rupture is accompanied by excessive mobility in the joint.
Treatment of injuries to the lateral ligaments of the knee joint
Traumatologists treat sprains and tears of the knee joint ligaments conservatively. The site of injury is anesthetized with a solution of novocaine. If there is a large amount of blood in the joint, a puncture is performed. A plaster splint is placed on the leg from the ankles to the upper third of the thigh.
Complete rupture of the medial collateral ligament is also treated conservatively. When the lateral collateral ligament is completely torn, surgical intervention is required, since its ends, as a rule, move away from each other, and independent fusion becomes impossible. During the operation, a lavsan suture of the ligament or its tendon autoplasty is performed. In case of ligament dissection, grafts are used. In the case of an avulsion fracture of the head, the bone fragment is fixed to the fibula with a screw.
When the ligament fusions, its length often increases due to scar tissue. As a result, the strengthening function of the ligament decreases, and the knee joint becomes unstable. If other joint structures (capsule, cruciate ligaments) do not compensate for this instability, reconstructive surgery (relocation of the ligament insertion or tendon grafting) is performed.
REHABILITATION AFTER ACL RUPTURE
- Modern physiotherapy for tissue and circulatory restoration: VTES, HILT, UVT;
- Orthotics and kinesiotaping;
- Exercise equipment with a rehabilitation medicine instructor will help strengthen your muscles and stabilize your knee.
Don't neglect professional medical help to easily avoid surgery and get back in shape quickly!