What is knee ligament repair?
Ligaments are the bands of tough, elastic connective tissue that surrounds a joint to give support and limit the joint's movement.
When ligaments are damaged, the knee joint may become unstable. Ligament damage often happens from a sports injury. A torn ligament severely limits knee movement. These results in the inability to pivot, turn or twist the leg. Surgery is another option to repair a torn ligament if another medical treatment is not effective.
There are 4 major ligaments in the knee. The ligaments in the knee connect the femur (thighbone) to the tibia (shin bone), and include the following:
- Anterior cruciate ligament (ACL) - The ligament which is located in the center of the knee that controls rotation and forward movement of the tibia.
- Posterior cruciate ligament (PCL) - The ligament, located in the center of the knee that controls a backward movement of the tibia.
- Medial collateral ligament (MCL) - The ligament that provides stability to the inner knee.
- Lateral collateral ligament (LCL) - The ligament that provides stability to the outer knee.
Why might anyone need a knee ligament repair?
The anterior cruciate ligament (ACL) is placed toward the front of the knee. It is the most common ligament which can be injured. The ACL is often stretched or torn during a sudden twisting motion. Skiing, basketball, and football are such sports that have a higher risk of ACL injuries.
The posterior cruciate ligament (PCL) is located toward the back of the knee. It is also a common knee ligament to be injured. But, the PCL injury generally happens with sudden, direct impact, such as in a car accident or during a football tackle.
The medial collateral ligament (MCL) is located on the inner side of the knee. Stretch and tear injuries to the collateral ligaments are usually caused by a blow to the outer side of the knee, such as when playing hockey or football.
Initial medical treatment for knee ligament injury may include:
- Ice pack
- Pain relievers
A knee ligament tear may be healed with the following:
- Muscle strengthening exercises
- Protective knee brace
- Activity limitations
Repairment of knee ligament is a treatment for a complete tear of a knee ligament that results in instability in the knee. People with a torn knee ligament may be unable to do normal activities that involve twisting at the knee. If medical treatments are not satisfactory, ligament repair surgery may be an effective treatment.
The surgery which is done to correct a torn knee ligament involves replacing the ligament with a piece of healthy tendon. A tendon from the kneecap or hamstring, for example, is grafted into place to hold the knee joint together. The tendon graft may come from the person (autograft) or from an organ donor (allograft).
What are the risks of knee ligament repair?
As with any surgical procedure, complications can happen. Some possible complications may include the following:
- Blood clots in the legs or lungs
Some people may experience pain, limited range of motion in the knee joint and occasional swelling in the knee after surgical ligament repair. Rest has increased motion in the knee joint as the graft stretches over time.
What happens during a knee ligament repair?
Knee ligament repair may be performed on an outpatient basis or rarely as part of the patient’s stay in a hospital. Procedures may differentiate depending on the patient’s condition and his healthcare provider’s practices.
Knee ligament repair may be performed while the patient is asleep under general anesthesia, or while he is awake under spinal anesthesia. When spinal anesthesia is used, the patient will have no feeling from his waist down.
Usually, knee ligament repair surgery follows this process:
- The patient will be asked to remove clothing and will be given a gown to wear.
- An intravenous (IV) line may be started in the patient’s arm or hand.
- The patient will be positioned on the operating table.
- The anesthesiologist will continuously monitor the patient’s heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
- The skin over the surgical site will be cleansed with an antiseptic solution.
- The doctor will make several small incisions in the knee area.
- The doctor will drill small holes in the tibia and femur where the torn ligament was attached.
- The doctor will thread the graft through the holes and attach it with surgical staples, screws, or other means. Bone eventually grows around the graft.
- The incision will be closed with stitches or surgical staples.
- A sterile bandage or dressing will be applied.
What happens after a knee ligament repair?
After the surgery, the patient will be taken to the recovery room for observation. The recovery process will differ depending on the type of anesthesia that is given to the patient. Knee ligament repair is usually done on an outpatient basis.
Once the patient is home, it is important to keep the surgical area clean and dry. The will give specific bathing instructions. The stitches or surgical staples will be removed during a follow-up office visit.
The patient can take a pain reliever for soreness as suggested by the doctor. Aspirin or certain other pain medicines can increase the chance of bleeding. Only recommended medicines should be taken.
To help reduce swelling, the patient may be asked to elevate his leg and apply an ice bag to the knee several times per day for the first few days. The doctor will arrange for an exercise program to help the patient regain muscle strength, stability, and range of motion.
Which are the different tests which have to be performed before Knee Joint Repair Surgery?
Some of the different tests which have to be performed before Knee Joint Repair Surgery are: