The Anterior Cruciate Ligament broken does not regenerate itself, melts as braided rope and should be replaced with a graft.
The graft is implanted adopts the same characteristics as the rest of ligaments from the fifth or sixth month of the intervention.
Types of ligament graft
In the grafts obtained from the same patient injured knee can distinguish three types:
- Hamstring: They are obtained from the tendons known as "goosefoot", prepared as quadruple bundle. The skin incision needed for collection is 2 cm.
- Patellar tendon: you get the lower end of the patella, patellar tendon third center and third distal bone insertion I. This area is regenerated completely after one year. The skin incision is 4cm to pick it up.
- Quadriceps tendon: is obtained from the upper end of the patella and quadriceps tendon third core area that regenerates completely and annually presents the same characteristics as previously presented. The skin incision is to pick 3.5cm
They can also be implanted grafts tissue bank, in these cases no accessory incision is required for graft. The choice between one or the other type of graft is mainly based on the type of lesion and patient characteristics.
Operation with Arthroscopic Anterior Cruciate Ligament
The Anterior Cruciate Ligament operation is performed by arthroscopy: with this technique only two or three incisions of 0.5 cm are required. knee implant the graft to anatomically and which is introduced through a tunnel formed in the tibia and the femur another.
Since the graft is implanted until the bone joins elapse several weeks, so that the bone graft must be attached to at least until blended at the same. Depending on the type of patient and the technique can be used for fixing bioabsorbable screws, a small button titanium or other fastening systems.
It must be set to a specific voltage and with the knee in a certain position. A low voltage is implanted graft in a weak and insufficient LCA, which will probably require revision surgery.
Postoperative Anterior Cruciate Ligament operation
After surgery, the operated limb is immobilized with a small elastic bandage can fully support the limb, but not until the next day start to bend and straighten the knee.
The patient prescription of traumatologist need two canes or crutches for two or three weeks, then one from the third week.
Finally, you can also specify stabilizing knee brace, mainly for walking during the first three weeks.
Rehabilitation after rupture of the Anterior Cruciate Ligament
Rehabilitation is a key factor in the patient's recovery after surgery LCA. It starts the day after the intervention, always attended by a Physiotherapist, where the patient perform exercises to strengthen the muscles of the thigh and calf:
- During the first days the goal is to completely extend the knee and flex more than 90 degrees.
- The next step is assisted physiotherapy in a rehabilitation center near the patient's home or place of work.
- One month after the operation can start sports like cycling and swimming.
- Two months and you can go jogging.
- They spend about 5 or 6 months until the implanted graft adopts the same characteristics as the ligament, so you can not resume sports activities impact decelerations such as tennis, football, skiing and dance before.
Anterior Cruciate Ligament Injury cartilage growth
Traditionally ACL injuries in children and adolescents have been fracture-avulsion of the tibial spine, which is treated with arthroscopic surgery.
ACL reconstruction is done using the same technique as in the adult but other methods of attaching the tendon graft saving cartilage growth are used; and tunnels are of smaller diameter, whereby the physiological and mechanical properties of the growth plate are not altered.