Anterior Cruciate Ligament Rupture is a common sporting injury most often seen in twisting/turning sports such as rugby, football, netball, skiing and motocross to name but a few. The Cruciate Ligament can also be torn as the result of everyday, non-sporting, accidents that involve twisting on a flexed knee.
The cruciate ligaments (anterior and posterior) criss-cross in the centre of the knee and are important for maintaining the rotational stability of the joint. Rupture of the Cruciate Ligament usually leads to quite rapid and significant swelling of the knee. As the swelling decreases the knee may remain painful and may be characteristically unstable and prone to episodes of ‘giving-way’, especially when twisting and turning.
Initial management of a Cruciate Ligament rupture involves the physiotherapist and rehabilitation to see whether or not the knee will become stable in day-to-day activities. Whether or not reconstruction is recommended will depend upon knee stability and on individual functional requirements and aspirations.
The majority of Cruciate Ligament ruptures seen in clinic will come to be offered ligament reconstruction for 2 principle reasons.
- Firstly, to stabilize the knee and prevent further episodes of giving way allowing return to normal sporting activity. (85% of patients under-going reconstruction return to sport at their pre-accident level).
- Secondly, Cruciate Ligament reconstruction is undertaken to limit the risk of late meniscal injury (tears caused by abnormal movement secondary to Cruciate Ligament deficiency), which might also help to reduce the risk of developing premature osteoarthritis of the knee.
Anterior Cruciate Ligament reconstruction is usually done as an arthroscopic procedure under general anaesthetic with the ligament usually being replaced by a graft made of hamstring tendons taken from the same leg. Any associated meniscal tears will be repaired or excised at the same time. The procedure can be undertaken as a day-case although it is not uncommon to stay in hospital overnight.
The post-operative phase of Cruciate Ligament reconstruction is very important to the long-term success of the procedure and will involve quite intensive physiotherapy for 3 or 4 months. Most patients use crutches for the first 2 to 3 weeks to allow the initial post-operative swelling to resolve. Non-manual workers may return to work 4 to 6 weeks after surgery, whereas manual workers are likely to be off work for 3 to 4 months to prevent injury to the new graft. Driving is avoided for 4 to 6 weeks with return to contact sport usually possible after about 9 months.
Are you suffering with a cruciate knee ligament injury? Hurt playing the sport you love?Why not make an appointment with the South West’s orthopaedic experts at VITA and let us help you get back on your feet?