Rupture of the anterior cruciate ligament of the knee is a condition that occurs due to injury. It is considered quite dangerous, but if the problem is identified in time and treated in time, minimal he alth consequences can be achieved. Athletes who play tennis, basketball and football most often suffer from this type of gap.
Description
There is a cruciform ligamentous apparatus in the knee. It is essential for the proper functioning of the joint. Also, thanks to this device, the knee is able to bend only at a certain angle. If strong pressure is applied to it, then stretching or tearing can occur. The name of the apparatus was given by two bundles of which it consists. One of them is front, the second is back. The gap can be either two ligaments at the same time, or only one of them. Locatedthey are in such a way that they form a cross.
Symptomatics of the rupture of the anterior cruciate ligament of the knee joint is quite pronounced. The patient's knee swells, and there is severe pain. The temperature may rise at the site of the rupture. At the time of injury, many hear a crunch or crack. In order to identify damage, it is necessary to conduct an external examination and prescribe some diagnostic methods. The rupture is treated only in stationary conditions, regardless of which ligament is injured. Both invasive therapy and surgical intervention are used.
Causes of occurrence
As a rule, a complete or partial rupture of the anterior cruciate ligament occurs as a result of injury. Less commonly, some inflammation leads to this. Consider the possible reasons:
- Falling from a height.
- Having an accident.
- Stumbling.
- The presence of inflammatory or degenerative processes in the knee joint. The condition is considered especially dangerous when they affect the ligamentous apparatus itself.
- Sharp knee movement. Intense jumping, sudden stopping after a fast run, and joint extension can lead to a subtotal ACL tear.
If we talk about provocative factors, then these should be noted:
- anatomical features of the human motor apparatus;
- hormonal problems;
- partially developed leg muscles.
Degrees of disease
Distinguishthree degrees of rupture, depending on the severity of the injury. When conducting treatment, it is necessary to identify which is inherent in a particular patient, this will allow for effective therapy. Also, each degree has its own symptoms:
- Microbreak. If you start treatment on time, then there will be no complications. There is no need for an operation. It is characterized by violations only in one part of the joint. Symptoms are weak, the person practically does not feel any manifestations.
- Partial break. In the medical field, this degree is also called subtotal. Symptoms are more noticeable than with a microfracture. In this case, there may be violations in the work of the cruciate ligament of the knee joint. Up to 50% of all fibers suffer. Treatment is complex. If an athlete received such an injury, then for his full recovery it is necessary to perform an operation.
- Complete rupture of the anterior cruciate ligament. Surgery is the only way to fix this problem. This is due to the fact that the ligamentous apparatus is completely torn and unable to function.
Symptomatics
What symptoms the patient will have depends entirely on the degree of damage to the joint. Most often, these manifestations occur:
- Knee swelling.
- Unstable limb functioning.
- High skin temperature at the injury site.
- During a fall or other mechanical injury, the patient feels a crunch.
- Hemarthrosis appears (not in all cases). This condition is characterized by the accumulation of blood in the injuredjoint.
- There is severe pain when falling, as well as when trying to move the device. If the latter is completely broken, then it will not be able to perform its supporting function at all.
If the patient has similar signs, then he must be urgently delivered to the medical center. institution. Also, with an injury to the cruciate ligament of the knee joint, it is important to provide first aid. The leg should be immobilized first so as not to lead to worse problems. Next, the knee must be fixed with a bandage or some kind of cloth. The patient should be given an anesthetic tablet, as well as apply cold to the affected area. The last action will reduce swelling and reduce pain.
Diagnostic Methods
Before prescribing treatment for a torn anterior cruciate ligament, it is necessary to carry out diagnostic measures. Only a specialist can identify such a problem. For this, an x-ray, ultrasound of the affected area is taken. Magnetic resonance imaging is also often prescribed. It will allow you to get complete information about the joint.
Treatment
It seems to many that the only way to close the gap is through surgery. In the event that it is not complete, only conservative treatment is allowed. It is used for rupture in children and the elderly. Partial pathology is often subjected to non-invasive methods of treatment. The leg should be fixed and not loaded. In certain cases, the doctor may put her in a cast.
Means are prescribed that stop the blood, reduce pain, strengthen the immune systemand the body as a whole, as well as fight inflammation.
At the second stage, exercises are assigned. After a rupture of the anterior cruciate ligament, it is physiotherapy exercises that will return the functionality of the limbs. Massage, physiotherapy and so on will not interfere.
The operation is performed only if the rupture is complete or partial, in which the medications did not lead to the desired result. During surgery, not only sutures are applied, but prostheses or grafts are also inserted. In this way, a full recovery can be achieved.
Treatment in the acute period
In order to cure an injury that is in an acute period as quickly as possible, it is necessary to apply cold and introduce drugs to relieve pain and reduce swelling. It is also necessary to limit the load on the limb.
At first you will have to use crutches. Any load on the affected knee will cause severe discomfort and lameness. If necessary, the doctor will aspirate blood. Sometimes it accumulates in an injured joint after an injury. For this procedure, you will need to use a syringe and a needle.
Once swelling and pain are completely eliminated, the patient only needs to restore normal range of motion. To do this, you need to exercise on an exercise bike. It also has a good effect in case of rupture of the anterior cruciate ligament of exercise therapy. Exercise will help restore the functionality of the muscles and the joint itself.
Most likely, the patient will be assigned to wear an orthosis. It is necessary in order to relieve the load on the joint, as well as increase its stability. They wear it for a small amount of time, for example, in preparation for surgery, so as not to worsen the condition, and in case of severe symptoms. After the intervention, the cut should be worn for about six months. Sometimes it is removed earlier. This way you can achieve successful engraftment of the transplanted ligament.
Restoration of the ligament (operation)
At the moment, when the anterior cruciate ligament is torn, an operation called arthroscopy is being performed. The surgeon tries to make as few incisions as possible. In some cases, the restoration of the affected ligament is done using the tendons and muscles of the patient himself. After the operation, the patient is allowed to go home the same day. If necessary, he is left for a couple of nights in the hospital.
Elderly people or athletes can use a special synthetic prosthesis to restore the ligament. Its advantages include strength and inertness. With its transplantation, aggressive rehabilitation can begin almost immediately. Of the shortcomings, low elasticity is distinguished.
Surgery using biomaterial
Anterior cruciate ligament tear is treated with tendons from a tender muscle. The surgeon uses an arthroscope, which allows you to control all the manipulations carried out inside the joint. Thanks to this technique, the doctor does not need to make large incisions. Due to this, the knee recovers quickly, healing also does not requirea lot of time.
Such operations are performed under spinal anesthesia. Surgical intervention begins with two punctures, which are no more than 4 mm in diameter. Through them, an arthroscope is inserted, as well as mini-instruments. After examining the joint and confirming the diagnosis, the surgeon makes a skin incision. Next, the semitendinosus and tender muscles are removed. Of these, material is allocated for the restoration of the ligament. The strength of the graft is quite high due to the fact that when replacing the tendon, the material is folded four times.
After that, the intercondylar space expands. This is necessary so that the graft is not damaged in the future. Immediately after this, holes are drilled into the bone. Material is entered through them.
Rehab
After the operation, it is important to follow all the rules of rehabilitation. This is the only way to achieve good results. The inserted autograft needs time to become a replacement for the anterior cruciate ligament. The recovery time for rupture is about 6 months.
You need to understand that a successful operation is only a 50% guarantee that a person will walk normally and play sports again. It is important to carry out the correct rehabilitation. She is prescribed jointly by a surgeon and a physiotherapist.
The first stage consists of treatments such as magnetotherapy and muscle stimulation. Also, the doctor will try to reduce the pain effect, reduce swelling and eliminate the existing wound. The limb must be fixed without fail so as not to load the diseased joint. Theperiod takes an average of a week.
The second stage of rehabilitation is to try to restore motor function. The patient can already gradually load the limb. Over time, the force of pressure on the joint and the range of its movements should be increased. The period lasts a month.
The third stage is necessary to restore a person's daily activities. You need to start training the muscles of the injured leg. This period takes an average of 2 months. It is allowed to return to sports only six months later, when the joint heals and you can forget about the rupture of the anterior cruciate ligament.
Rehabilitation after transplant implantation
If a patient has undergone an operation to introduce an autograft for plastic surgery of the device, then the rehabilitation period takes on a slightly different look. The first few days you will have to walk with an orthosis. However, after 3-4 weeks, you can return to your usual lifestyle.
Results
When the anterior cruciate ligament is torn, treatment should be started immediately. This is the only way to get rid of various consequences that can greatly spoil the conditions of human life.
The patient will first be treated with medication if the gap is minimal. In the event that therapy becomes ineffective, the patient will be offered to undergo surgical intervention. The operation can be performed using synthetic materials or using the muscles and tendons of the patient himself. If we are talking about the recovery of athletes, then, as a rule, for their successfulcures use autografts. They are considered more reliable and as efficient as possible.
It should be remembered that you need to protect your body from injury. This is the only way to avoid unpleasant diseases and symptoms.
