Injuries to the anterior cruciate ligament of the knee are always high-energy injuries that occur with excessive rotation in the joint with a fixed foot. Football players, skiers, snowboarders know firsthand about injuries to the knee joints, and in particular the anterior cruciate ligament. Professional sports are always incredibly beautiful, but they also expose the athlete to an increased risk of injury.
Despite the fact that sports injuries account for a large proportion of ACL injuries, patients in everyday life can also encounter a similar unpleasant event. Most often, in life outside of sports, this is a consequence of road accidents, or direct targeting of an injurious agent into the knee joint.
The moment of injury to the anterior cruciate ligament will never go unnoticed by the patient:
- sharp pain and crunching in the joint
- rapid development of joint swelling with a significant increase in its volume
- a feeling of joint instability
- impossibility of active full movements in the joint, difficulty in flexion-extension
ACL injury is a serious injury that can put a sports career on hold for 6-12 months, as well as lead to irreversible degenerative consequences in the joint, if not treated promptly and correctly.
Rudenko Medical Center is a guarantee of qualified and attentive treatment of anterior cruciate ligament injuries of the knee joint with an individual approach and rehabilitation aimed at the patient's earliest possible return to normal life without any mention of the injury. We know exactly how to act even in the most difficult cases, including when working with professional athletes.
During the first examination, a traumatologist at the Rudenko Medical Center will indicate ACL damage:
- drawer sign - a diagnostic test in which the doctor passively attempts to move the lower leg forward relative to the hip, simulating the movement of a drawer, and the lower leg is subjected to pressure
- Lachmann's test - the most sensitive manual test, performed while lying on the back with the knee slightly bent. The test is similar to the drawer sign, but allows you to assess the extent of the anterior displacement of the lower leg and is useful immediately after injury, even without instrumental imaging methods, when the drawer sign may still be absent or mild
Magnetic resonance imaging (MRI) is used to obtain additional information in ACL injuries, to assess not only the condition of the ligament, but also other adjacent structures. If necessary, radiography or computed tomography of the knee joint can be used to exclude bone fractures.
Treatment of anterior cruciate ligament ruptures
It is important to understand right away that it is not always possible to restore the integrity of an already damaged ligament. The only exceptions are fresh proximal tears, at the point of attachment of the ligament to the femur, which are no more than 3 weeks old.
The mandatory conditions will be:
- preserved ligament structure, no delamination of its fibers
- high patient loyalty to long-term rehabilitation, his motivation and discipline
- low risk of repeated ruptures (i.e., such surgical tactics will be irrelevant for athletes)
If this is the case, the traumatologist at the Rudenko Medical Center will consider the following surgical methods for you:
- reconstruction of the anterior cruciate ligament with its longitudinal support fixation with a biological reinforced tape using InternalBrace technology
This combined technique reduces the load on the repaired ligament, ensures its stability and potentially shortens the rehabilitation period.
- BEAR technique
The technique involves the use of a special biodegradable spongy substance made from bovine tissues. The sponge is attached to the edges of the anterior cruciate ligament with sutures, like a frame bridge, and then saturated with the patient’s own blood. The technique ensures the restoration of the patient’s own ligament tissues, promoting their gradual self-repair. Over time, when the ligament restores its structure, the spongy substance will dissolve in the body on its own without any traces.
In all other clinical situations, classical approaches to the reconstruction of the anterior cruciate ligament using grafts are used, i.e., replacing the ACL tissue. For this, “tunnels” are formed in the bones along the anatomical course of the ligament, and the graft is fixed using special screws. The surgical intervention is performed under general anesthesia using arthroscopy – a minimally invasive technique through small incisions in the skin under the control of video navigation. This ensures minimal duration of the intervention, virtually no blood loss, and the possibility of full control by the surgeon over the course of the intervention and assessment of the condition of the intra-articular structures.
The following types of grafts – tissues for transplantation are used:
- Allografts – donor tissues
- Autografts – patient’s own tissues: grafts from patellar tendon, hamstring tendon, quadriceps tendon
- Synthetic grafts
Anterior cruciate ligament plastic surgery is performed at the Rudenko Medical Center on a “same-day surgery” basis, but we always take into account the individual needs of each patient. The advantages of this approach are difficult to overestimate.
- No need for long-term hospitalization
- Full postoperative supervision by medical staff and adequate pain relief
- Training on the correct distribution of the load on the operated limb
- Consultation with a rehabilitation doctor and development of a rehabilitation plan taking into account personal wishes and specifics of sports training, if any
After the surgery, it will be necessary to immobilize the limb with an orthosis or a trainer for a certain period of time until the operated ACL is ready for rehabilitation. Our staff is always ready to help you with the selection and adjustment of the gadget.
Rudenko Medical Center is a symbiosis of many years of experience, openness to new tactics in classic clinical situations, as well as a sincere desire to help - this is what makes us professionals in our fields. Be healthy together with Rudenko Medical Center.