Cruciate Ligament Tear Treatment
The knee is a complex joint formed by numerous interconnected structures. These provide mobility and stability. Ligaments maintain stability and ensure proper movement of the joint. An injury to the knee ligaments can be serious, the most frequent is an anterior cruciate ligament tear.
Cruciate ligament rupture
The anterior cruciate ligament (ACL) is one of the four ligaments present in the knee, along with two medial and one posterior cruciate ligament. The ACL is essential to avoid anterior displacement of the tibia with respect to the femur. Although there are two cruciate ligaments, the reference to the ACL is more frequent.
An ACL tear usually occurs while playing sports. It’s a common injury in sports such as soccer, basketball, hockey, and skiing. In skiing, i t can occur during the race, while braking or changing direction. In these situations, the ligament stretches too far and ends up tearing.
It’s interesting to know that, in many cases, when the cruciate ligament ruptures, one of the lateral ligaments and the meniscus do as well. When these three injuries occur together, it’s known as a knee triad.
Treatment for a cruciate ligament tear
Prevention
It’s very important to promote the prevention of this injury, which in recent years is becoming an epidemic among athletes. The best way to prevent this condition is to perform a proper warm-up, and practice mobility exercises several times a week. You must also allow your body to properly rest after physical activity.
It’s also important to know your body and know when you’re reaching your physical limits. In this sense, you’re responsible for taking care of your health.
General treatment
Once the injury has occurred, the patient must take certain measures until they receive the definitive treatment; which is surgery in a large percentage of cases. Until you’ve had surgery, you should rest and keep the joint as still as possible. This is because movements can aggravate the tear and worsen the prognosis.
It’s recommended that you use a compression bandage and apply ice to reduce inflammation. If there’s a significant amount of pain, you may require anti-inflammatory drugs. You should use crutches to walk since there should be no weight-bearing on the injured leg.
Conservative treatment
Conservative treatment includes muscle and joint strengthening techniques. This method is for less active people who aren’t often physically active and whose injury was an accident.
In these cases, rehabilitation will be longer and it’ll be aimed at recovering all possible mobility of the knee joint. However, the patient will never recover full knee functionality.
For this reason, when the injury occurs in athletes, young people and individuals who want to maintain an active lifestyle, it’s appropriate to recommend surgery.
Surgical treatment
If athletes want to continue playing sports at a competitive level, the recommendation for them is surgery. Surgery is also recommended in patients who’ve injured other parts of the knee, such as, another ligament, the meniscus and, especially, in the knee triad.
The treatment is performed by open surgery or by arthroscopy. Today the tendency is to perform arthroscopy, in which the surgery is performed via a camera through small incisions. The surgeon replaces the injured ligament with a donor cadaver — allograft. The surgeon may also perform a substitute with muscle tissue which is called plasty — an autograft.
Since arthroscopy is much less invasive than open surgery, the patient experiences less inflammation and less pain following their surgery. Similarly, they’ll stay in hospital for less time and their recovery will be quicker.
However, in cases where access by arthroscopy is too difficult due to the patient’s conditions, open surgery is necessary.
In summary, these are the different ways to treat a cruciate ligament tear. It’s a serious injury, so it’s always necessary to follow the doctor’s instructions and achieve a proper recovery.
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- Paschos NK, Howell SM. Anterior cruciate ligament reconstruction: principles of treatment. EFORT open Rev [Internet]. 2016 Nov [cited 2019 Jun 15];1(11):398–408. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28461919
- Nyland J, Mattocks A, Kibbe S, Kalloub A, Greene JW, Caborn DNM. Anterior cruciate ligament reconstruction, rehabilitation, and return to play: 2015 update. Open access J Sport Med [Internet]. 2016 [cited 2019 Jun 15];7:21–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26955296