Rupture of the anterior cruciate ligament of the knee joint is a condition that occurs due to trauma. It is considered quite dangerous, but if you identify the problem in time and carry out treatment, you can achieve minimal health consequences. Most often, a gap of this type affects athletes who play tennis, basketball and football.
Description
In the knee there is a ligamentous apparatus of a cruciform shape. It is necessary 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 exerted on it, then tension or rupture may occur. The name of the device was given by two bundles of which it consists. One of them is front, the second is back. The gap can be both simultaneously two ligaments, and only one of them. They are located in such a way that they form a cross.
Symptoms of rupture of the anterior cruciate ligament of the knee joint are manifested quite clearly. Patient's knee swells and severe pain occurs. At the point of rupture, temperature may rise. At the time of injury, many hear a crack or crack. In order to detect damage, it is necessary to conduct an external examination and prescribe some diagnostic methods. They treat the gap only in stationary conditions, regardless of which ligament is affected. Both invasive therapy and surgical intervention are used.
Causes of occurrence
Typically, a complete or partial rupture of the anterior cruciate ligament occurs as a result of injury. Less commonly, some inflammations result. Consider the possible reasons:
- Falling from height.
- Accident
- Stumbling.
- The presence of inflammatory or degenerative processes in the knee joint. Especially dangerous is the condition when they affect the ligamentous apparatus itself.
- Abrupt movement of the knee. Intense jumping, sudden stopping after a quick run and extension of the joint can lead to subtotal rupture of the anterior cruciate ligament.
If we talk about provoking factors, then these should be noted:
- anatomical features of the human motor apparatus;
- hormonal problems;
- partially developed muscles on the legs.
Degrees of disease
There are three degrees of rupture, depending on the severity of the injury. During the treatment, it is necessary to identify which is inherent in a particular patient, this will allow for effective therapy. Each degree also has its own symptoms:
- Microfracture. If treatment is started on time, there will be no complications. There is no need for an operation. It is characterized by violations only in one of the joints. The symptomatology is weak, a 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 microfracture. In this case, violations may occur during the operation of the cruciate ligament of the knee joint. Suffers up to 50% of all fibers. The treatment is comprehensive. If an athlete received such an injury, then for his full recovery it is necessary to conduct 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 breaks completely and is not able to function.
Symptomatology
What symptoms the patient will have depends entirely on the degree of damage to the joint. Most often, such manifestations occur:
- Swelling of the knee.
- Unstable functioning of a limb.
- High skin temperature at the site of injury.
- During a fall or other mechanical damage, the patient feels a crunch.
- Hemarthrosis appears (not in all cases). This condition is characterized by the accumulation of blood in an injured joint.
- There is severe pain when falling, as well as when trying to carry out the movement of the apparatus. If the latter is completely torn, then it will not be able to perform its support function at all.
If the patient has such signs, then he must be urgently delivered to honey. institution. Also, with an injury to the cruciate ligament of the knee joint, it is important to provide first aid. First, the leg should be immobilized so as not to lead to worse problems. Next, the knee must be fixed with a bandage or some kind of cloth. The patient needs to be given a pill of pain medication, and also apply cold to the affected area. The last action will reduce swelling and reduce the pain effect.
Diagnostic Methods
Before prescribing treatment for rupture of the anterior cruciate ligament, it is necessary to conduct diagnostic measures. Only a specialist can identify a similar problem. To do this, do an x-ray, ultrasound of the affected area. Often, magnetic resonance imaging is also prescribed. It will provide complete information about the joint.
Treatment
It seems to many that closing the gap is possible only 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 foot should be fixed and not loaded. In certain cases, the doctor may plaster it.
Assigned drugs that stop the blood, reduce pain, strengthen the immune system and the body as a whole, and also fight inflammation.
At the second stage, exercises are prescribed. After rupture of the anterior cruciate ligament, it is physiotherapy exercises that will restore limb functionality. Do not interfere with massage, physiotherapy and so on.
An operation is carried out only if the gap is full or partial, in which medications did not lead to the desired result. During surgery, not only sutures are inserted, but dentures or grafts are also inserted. So you can achieve a full recovery.
Acute treatment
In order to cure an injury that is in the acute period as quickly as possible, it is necessary to apply cold and introduce drugs that can relieve pain and reduce swelling. It is also necessary to limit the load on the limb.
At first, you have to use crutches. Any load on the sore knee will cause severe discomfort and lameness. If necessary, the doctor conducts blood aspiration. Sometimes it accumulates in an injured joint after an injury. For this procedure, you will need to use a syringe and a needle.
After the swelling and pain are completely eliminated, the patient only needs to restore the normal range of motion. To do this, you need to exercise on a stationary bike. It also has a good effect when the anterior cruciate ligament of exercise therapy is torn. 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 stress on the joint, as well as increase its stability. They wear it 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. So you can achieve successful engraftment of the transplanted ligament.
Ligament restoration (operation)
At the moment, when the anterior cruciate ligament is torn, an operation called arthroscopy is performed. In this case, the surgeon tries to perform 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 surgery, the patient is allowed to leave home on the same day. If necessary, he is left for a couple of nights in a hospital.
Elderly people or athletes can use a special synthetic prosthesis to restore ligaments. Its advantages include strength and inertness. With his transplantation, you can begin aggressive rehabilitation almost immediately. Of the disadvantages emit low elasticity.
Operation using biomaterial
In the treatment of rupture of the anterior cruciate ligament, tendons from the tender muscle are used. The surgeon uses an arthroscope, which allows you to control all the manipulations performed inside the joint. Thanks to this technique, the doctor does not need to make large incisions. Due to this, the knee is restored quickly, healing also does not take much time.
Such operations are performed under spinal anesthesia. Surgical intervention begins with two punctures, which are no more than 4 mm in diameter. An arthroscope is introduced through them, as well as mini-instruments. After examining the joint and confirming the diagnosis, the surgeon makes a skin incision. Then semitendinous and tender muscles are seized. Of these, ligament restoration material is released. The strength of the graft is quite high due to the fact that when replacing a tendon, the material is folded four times.
After this, the intercondylar space expands. This is necessary so that the transplant is not damaged in the future. Immediately after that, holes are drilled into the bones. Through them, material is introduced.
Rehabilitation
After the operation, it is important to follow all the rules of rehabilitation. Only in this way can good results be achieved. The autograft introduced takes time to become a replacement for the anterior cruciate ligament. The recovery time at break is about 6 months.
You need to understand that a successful operation is only 50% of the guarantee that a person will again walk normally and play sports. It is important to conduct proper rehabilitation. She is prescribed jointly by a surgeon and a physiotherapist.
The first stage consists of procedures 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 should be fixed without fail so as not to burden the affected joint. This period takes an average week.
The second stage of rehabilitation consists in attempts to restore motor function. The patient can already gradually load the limb. Over time, the 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 everyday human activity. It is necessary to begin to train 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 grows together and you can forget about breaking the anterior cruciate ligament.
Rehabilitation after graft implantation
If the patient underwent surgery to introduce some kind of autograft for the plasty of the device, then the rehabilitation period takes on a slightly different look. The first few days will have to walk with an orthosis. However, after 3-4 weeks you can return to your usual way of life.
Summary
If the anterior cruciate ligament ruptures, treatment should be started immediately. Only in this way can one get rid of various consequences that can greatly ruin a person’s living conditions.
The patient will first be treated with medication if the gap is minimal. In the event that therapy becomes ineffective, the patient will be asked to undergo surgery. The operation can be performed using synthetic materials or using the muscles and tendons of the patient himself. If we are talking about the restoration of athletes, then, as a rule, autografts are used to successfully cure them. They are considered more reliable and most effective.
It should be remembered that you need to protect your body from injury. This is the only way to avoid unpleasant diseases and symptoms.