When operating a cruciate ligament injury?

Written by: Dr. Mikel Aramberri Gutiérrez
Edited by: Top Doctors®

Cruciate ligament rupture is one of the quintessential injuries suffered by athletes, because of the continuous overexertion and sudden changes of pace or direction of movement.   

The cruciate ligaments are responsible for giving the anteroposterior knee stability, vital for sports. The cruciate ligament is most often injured is the anterior cruciate ligament (ACL) in sports such as football, skiing and rugby. The injury usually occurs in a gesture of twisting the knee with the foot flat on the floor or a gesture of sudden hyperextension. In many cases, these fractures usually produce a 'crack' audible and knee swells in the course of a few hours.

Normally, the stroke disappears after a few days with ice and anti-inflammatories, but often the patient the "loose" or feel unstable knee.


When do we operate and which are not?

The main factor in deciding the operation is the degree of instability felt by the patient. There are patients who are not able to run by instability and, in certain gestures, such as swinging simply playing basketball, they can cause a failure by the ACL injury and end up suffering a fall with new knee effusion.

Other factors to consider are age, if it is associated with rupture of internal or external meniscus, the level of sport that takes the patient and the type of sport, among others. In cases of sedentary people, it can initially refer the patient to perform rehabilitation and rescan the knee after 6-8 weeks to assess the function of the damaged ligament.


What is the operation?

The operation in which a torn ACL with a graft, which will heal in the same place as the original ligament replaced is called LCA plasty. This graft can be of three types:

- Hamstrings patient's own: both internal and semitendinoso- -recto tendons are removed through a small incision in the front of the knee. Once extracted, prepared and tightened to be tunneled to the place of the original ACL.- Patellar tendon: Take associated with bone, in what is called a graft bone-tendon-bone. Allows the bone ends of the plasty heal within femur and tibia, and played left patellar tendon anatomy and functionality of the LCA.- Allograft tendon: grafts from a tissue bank from a donor. They can be hamstring or patellar tendon. These grafts have the advantage of less surgical aggression.


Typically, rehabilitation begins the day after the operation to complete different phases of it and return to competition at approximately 6 months. Initially consist of a series of exercises that strengthen the quadriceps and soft flexo extension exercises (stretching and flexing movement of the affected leg). And then from 3 weeks it is convenient to go to a rehabilitation center where professional therapists will help you with all the ongoing work to complete the recovery, rehabilitation and return to sport.

*Translated with Google translator. We apologize for any imperfection

By Dr. Mikel Aramberri Gutiérrez
Orthopaedic Surgery

Dr. Mikel Aramberri Gutierrez is a leading specialist in traumatology, member of the medical team of Real Madrid and medical coordinator of the Medical Service of the National Rugby Team. Works in Alai Sports Medicine Clinic, a multidisciplinary clinic sports traumatology.

It is particularly expert in treatments such as recurrent shoulder dislocation and bone reconstruction using arthroscopic stop severe instabilities. Great experencia breaks in supraspinatus, the acromioclavicular arthropathy, calcific supraspinatus tendinitis, ruptured cruciate ligament and osteoarthritis shoulder / knee.

*Translated with Google translator. We apologize for any imperfection

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