What you do not know about cruciate ligament surgery
Cruciate ligament surgery became popular among sports players because they are the most vulnerable to it, but what is cruciate ligament surgery? What are its causes and are there complications? And other questions we provide you with a detailed answer in the following article.
Cruciate ligament surgery
The cruciate ligament is one of the knee ligaments that is most susceptible to tearing or cutting, especially for sports people, including football and basketball players. The cruciate ligament is the link between the femur and shin bone, which ensures that the person’s movement is regular and balanced.
A person can rupture the cruciate ligament, especially the anterior cruciate ligament, as a result of several reasons, which causes severe pain, a feeling of tingling in the affected part and hearing a crackling sound. The injury may also result in infections and damage to the knee joint unless it is treated quickly.
Causes of a cruciate ligament rupture
Many studies worked on clarifying the most common causes of cruciate ligament rupture, including the following:
- Cruciate ligament rupture occurs as a result of a sprain or deviation in the leg, and it occurs for more than one reason.
- A person can rupture the cruciate ligament due to a violent side impact.
- A quick and sudden change of running at full speed.
- Jumping or spinning incorrectly.
- Sudden stop of the player.
The difference between the posterior and anterior cruciate ligaments
It is considered that the rupture or damage of the anterior cruciate ligament is the most prevalent, especially in women athletes, because the diameter of the cruciate ligament in women is less than in men, and this requires a compressive force of fewer than 2400 kilograms to be torn or injured.
As for the rupture of the posterior cruciate ligament, it is one of the least common injuries because it is more powerful than the anterior cruciate ligament, and therefore its injury is more difficult and is often the result of traffic accidents in which the posterior cruciate ligament collides with the interior of the car.
It is possible to perform repair surgery in the front and back ligaments so that the person can regain his normal activities and there is a greater possibility for the players to return to their sports regularly, and there is more than one reason why the cruciate ligament operation is necessary.
Is cruciate ligament surgery necessary?
There are more than one reason why cruciate ligament surgery is necessary for injured people, including:
- If the patient did not respond to other types of treatment, whether home or medication.
- In some cases of injury, a large cut of more than two-thirds of the cruciate ligament can occur, and surgical intervention is required in this case.
- Increased damage to the joint, whether from an injury to the meniscus or inflammation of the joint.
Anterior cruciate ligament surgery
The anterior cruciate ligament operation is one of the one-day operations that may enable the person to return home on the same day. The surgery is performed under the influence of complete anesthesia for the person, and the ligament is replaced with another with new tissue to repair the tear that occurred in the knee.
The doctor can use ligaments from the body from the thigh to treat the cruciate ligament with it and work to support the knee and increase its flexibility, which enables the person to practice his normal activities again while preserving the instructions given to him by the doctor.
During the operation, the attending physician replaces the torn ligament and puts a new one to connect the muscles with the bones, thus the person feels better and can stand and move with balance and the pain caused by the rupture or cutting of the cruciate ligament goes away. The surgery is performed in about an hour, after which the patient returns to the recovery room.
Posterior cruciate ligament surgery
The posterior cruciate ligament is part of the four ligaments in the knee, which works to connect the bones of the thigh (Femur) and the bones of the tibia (Tibia) and works on it, and it works to prevent the bones of the shin bone from moving from its place.
The posterior cruciate ligament injury occurs as a result of several reasons, but most of them are in athletes and violent sports practitioners that place excessive pressure on the posterior cruciate ligament, leading to its rupture or cutting, although the anterior cruciate ligament injuries are more common than the posterior cruciate ligament.
Some symptoms indicate a person’s posterior cruciate ligament injury, including knee swelling accompanied by pain and difficulty in bending it, and symptoms of infection and delay in treatment may develop into knee stiffness, fever, and walking problems.
Degrees of posterior cruciate ligament injury
There is a gradation in the types of injuries that occur in the posterior cruciate ligament, which are:
- The first degree: there is a partial tear in the posterior cruciate ligament.
- The second degree: The back of the cruciate ligament can be injured and stretched.
- The third degree: the knee rupture can increase and affect the entire ligament.
- The fourth degree: the knee is completely damaged and its ligaments are torn.
Posterior cruciate ligament treatment
There is more than one procedure that is taken to treat the cruciate ligament rupture, depending on the patient’s condition and the extent of the damage to the knee, including the following:
- Cold water compresses can be used to reduce swelling and severe pain.
- Use crutches and assistive devices to help you move around during an injury.
- Resorting to physical or natural therapy, including doing some exercises underwater in swimming pools.
Posterior cruciate ligament surgery
In some cases that develop to the third or fourth degree of tearing and cutting the posterior cruciate ligament, the doctor may advise that surgery should be performed on the ligament to replace it internally, i.e. any change, with another of one of the affected tendons of the body.
The posterior cruciate ligament operation is performed through total anesthesia of the body and is performed within an hour or less, after which the patient begins to recover, and the patient can return to practicing his life normally within a period ranging from 26 to 52 weeks after the surgery by adhering to the instructions of the attending physician.
Doctors advise, after performing the posterior or anterior cruciate ligament operations, to follow the appropriate rehabilitation methodology for the person to be more able to return to practicing his normal life in a better way than before.
Arthroscopic cruciate ligament surgery
Endoscopy or performing the cruciate ligament operation through binoculars has become one of the famous operations that treat partial or total rupture of the ligaments and limit the increase in symptoms that occur to the person after the injury. This process is determined according to the examinations and x-rays that the attending physician requests from the injured person.
The cruciate ligament operation is performed by inserting a thin tube at the end with a light source and a camera so that an internal exploration and treatment of the torn cruciate ligament is performed without the need for a large wound because the tube needs to be cut a few millimeters in length, and its healing is fast and leaves no noticeable trace.
Types of endoscopic cruciate ligament surgery
There is more than one type of cruciate ligament surgery laparoscopically, which helps the knee to return to its normal activity and function as before, and the types are:
- Anterior cruciate ligament repair surgery
The anterior cruciate ligament that was partially ruptured is repaired through binoculars, and this surgery works to suture the ligament again to reach a state of recovery, but there is a high probability of the rupture returning, so doctors prefer complete repair operations.
- Anterior cruciate ligament reconstruction
The reconstruction process is one of the surgeries preferred by doctors because it works by removing the torn cruciate ligament, which causes pain and difficulty in moving the leg evenly and replacing it with another tendon from the knee or a suitable part of the body, which ensures faster healing.
When should cruciate ligament surgery be performed laparoscopically?
There is more than one type of treatment that can be followed in cruciate ligament injuries, and the person can recover without the need for a special operation in the first degree of cruciate ligament rupture, but it is possible in other cases of injury and exposure of the ligament to a stronger rupture and an effect on the cartilage of the knee joint.
If the knee injury impedes movement or reduces the daily activity level of the injured person, or if the knee is unstable and affects its structure, the surgical intervention must be faster in order not to increase the damage in the cruciate ligament and damage the cartilage or adjacent bones.
Steps followed before cruciate ligament surgery
The doctor must perform some procedures before the operation takes place in order for the success rate to be higher, these procedures are:
- Sometimes the doctor will wait until the swelling in the knee goes down.
- The doctor can start with physical therapy and rehabilitation before the operation as well.
- The doctor can wait until the muscles regain strength.
How to perform cruciate ligament surgery arthroscopically
Cruciate ligament surgery laparoscopically is one of the operations recommended by doctors because it does not require deep incisions in the body and the procedures followed during the operation are:
- Two or three incisions are made through a small opening on one side of the knee.
- The endoscope is used in order for the doctor to reach the extent of the damage to the knee.
- The doctor inserts the necessary tools through another opening in the knee and performs the necessary repair.
- The joint is sterilized with a special liquid after the procedure.
Laparoscopic cruciate ligament surgery duration
The duration of the surgeries is usually due to the patient’s condition and the extent of the damage that occurred to the affected part, but the cruciate ligament surgery usually ranges from an hour to 3 continuous hours, and the patient remains in the hospital for one day, after which he can start the rehabilitation program designated for him.
Procedures after laparoscopic cruciate ligament surgery
Doctors recommend some signs that the patient should follow after the cruciate ligament surgery during the rehabilitation period, which help the patient to return to his normal activity. Full recovery from cruciate ligament injuries may take some time for the person to regain full fitness.
As a result of the operation, the knee may become swollen, and in normal times the following instructions help to reduce the swelling of the knee:
- The patient needs to take rest and work to keep the knee in a straight position and raise the leg and this helps in bringing it as close to the heart as possible to reduce swelling.
- In the event of swelling of the knee, the person can use pressure bandages during the day.
- Cold water compresses may help reduce knee swelling and relieve pain.
- The doctor can prescribe types of painkillers and anti-inflammatory drugs, and they are gradually reduced.
Is it possible to live with cruciate ligament severance?
There is more than one degree of a knee injury, from a simple rupture to the ligament being cut and separated into two parts, the tear can affect the patient’s range of motion, impair his ability to control the knee, and the femur or shin bone may slip.
In the event of laxity in the cruciate ligament or partial rupture, some conservative measures and non-surgical treatments can be followed that help treat the cruciate ligament and relieve the symptoms associated with the injury.
Cruciate ligament treatment without surgery
- Ice packs can be used to reduce swelling in the knee and reduce pain associated with the injury
- Raise the leg so that it is at the level of the heart and do not bend the knee too much.
- Reducing any load on the knee and using physical therapy to strengthen other muscles and ligaments.
- Using a knee brace because it gives greater support to the knee so that the damage to it does not increase.
Cutting the cruciate ligament is one of the cases in which doctors recommend surgeries that rebuild the cruciate ligament, which enables the person, especially the players of high-load sports such as football and basketball, to restore their normal activity.
Is cruciate ligament surgery dangerous?
Cruciate ligament surgery, like other surgeries, the patient may then be exposed to some complications, and this is due to the skill of the treating doctor and the extent of the patient’s commitment to the guiding instructions recommended by the doctor, and the cruciate ligament surgery may cause the following:
- Bacterial infection can occur after the procedure.
- Bleeding from surgery.
- In some cases, there may be health problems associated with the operation due to anesthesia.
- Knee pain can come back again.
- Failure to properly diagnose the affected condition may cause joint damage and stiffness.
The good choice of the doctor, the extent of his previous experience in cruciate ligament operations, as well as working on preparing a rehabilitation program that suits the patient’s condition and submitting to the instructions of the attending physician in a better way usually helps the patient to reach the stage of full recovery safely.
Rehabilitation before cruciate ligament surgery
Deciding to perform the cruciate ligament operation requires some procedures that the specialist doctor helps you with before the surgery to increase its success rate and allow the person to recover faster, and sometimes the doctor may be content with rehabilitating the patient physically to recover without needing surgery.
Tips before cruciate ligament surgery
After the cruciate ligament injury is diagnosed, the doctor can determine for him some procedures that work on recovery without surgery, and there are some tips that the patient can be rehabilitated with before determining the surgical operation – if necessary – which are:
- Physical therapy: A cruciate ligament injury can undergo physical therapy and rehabilitation after the injury for up to four weeks to strengthen the muscles and work to increase the flexibility of the knee.
- Non-surgical treatment: using cold water compresses, knee braces, and raising the leg up helps reduce the severity of the injury and reduce swelling.
- Psychological rehabilitation: Psychological support from the doctor and the people surrounding the injured person can contribute to his treatment and increase the success rate of the procedures currently in use.
How to prepare the patient before cruciate ligament surgery
In severe cases of cruciate ligament injury, which is a cut, the aforementioned procedures may not be sufficient to treat the ligament and return the injured person to his normal activity, so the doctor may advise prompt surgical intervention in order not to increase the complications of the injury.
The procedures followed before cruciate ligament surgery are:
- Carry out the necessary medical examinations
In the first stage, a thorough diagnosis of the patient’s condition is carried out using X-rays and magnetic resonance imaging to clarify the condition of the joint and the internal tissues of the knee, as well as important blood tests before resting to see if there are other health problems such as inflammation in the body.
- Knowing the patient’s medical history
It is important for the attending physician to know the patient’s full health condition, to know the medications that the person is taking, and to identify the presence of other diseases such as high blood pressure and diabetes, and also to determine whether the person is facing a problem with anesthesia.
- Clarify the instructions before the procedure for the patient
At this stage, the doctor explains the procedures that the patient must take immediately before the operation, including refraining from eating food for not less than 6 hours before the operation and not drinking water two hours before the surgery, and the doctor also indicates that paying attention to personal hygiene is an important factor and reduces the risk of complications.
Physical therapy before cruciate ligament surgery
There is more than one type of treatment that can be followed with a cruciate ligament injury, and this is due to the doctor’s diagnosis and the degree of rupture that occurred to the ligament, the doctor often uses non-surgical procedures that help heal the rupture and heal the patient in first-degree injuries of the cruciate ligament rupture.
Conservative treatment of the cruciate ligament
It is some of the instructions that the specialist doctor gives to the patient, include adherence to complete comfort, not bending the knee completely, and using ice as compresses to reduce swelling, and the person can also use pillars and braces so that no extra burden falls on the knee.
Alternative medicine treatment of the cruciate ligament
Using massage or Chinese herbs may play a role in speeding up a person’s recovery and reducing any complications affecting the joint or other tendons.
Cruciate ligament physical therapy
Physiotherapy and psychological and physical rehabilitation before the cruciate ligament surgery are very important because it works to improve the body’s response to treatment and works to strengthen the muscles and tendons so that the knee does not bear more weight than necessary during the injury period.
It is possible to do pre-operative exercises for the cruciate ligament, which help support the knee and restore its functions properly, and these activities must be supervised by a doctor in order not to make any mistake that increases the injury, the exercises are:
- Thigh muscle exercise: The patient lies on the back and rises slightly from the ground using the elbows, while joining the buttocks as much as possible, holding this position for 6 seconds, and repeating the exercise from 8 to 12 times a day.
- Heel raising exercise: It is done by standing up straight, then resting the hands on something low such as a chair, and starting to raise the heels slightly while keeping the knee straight and steady for 6 seconds, and repeating the exercise from 8 to 12 times.
- Quadriceps muscle exercise: The patient can sit on the ground with the right foot bent and the injured foot extended, and begin to slowly tighten the muscles above the knee down for 6 seconds, rest for 10 seconds, and repeat in one day from 8 to 12 times.
Is the cruciate ligament cutting painful?
The pain of cruciate ligament injuries varies in intensity from tearing to cutting, and the complete cutting of the cruciate ligament is the most difficult and causes severe pain, and the injured person may find it difficult to move or stand in a balanced manner, and he must refer to a specialized doctor to start treatment and reduce the pain caused by the injury.
Rehabilitation after cruciate ligament surgery
Cruciate ligament surgery is one of the delicate surgeries that require some procedures and rehabilitation, whether before or after the operation, which ensures that the success rate of the operation is higher and that the person recovers as quickly as possible, and we explain in the following some tips that are used after the cruciate ligament operation:
- Discuss post-operative instructions with the specialist doctor
After performing the cruciate ligament operation, the doctor begins to determine the procedures that the injured person must follow during the recovery period, explains to him the instructions that must be followed at present, and shows him when to start physical therapy, and can discuss with him the medications that you take during the recovery period.
- Get enough rest
Post-operative rest is an important piece of advice because it helps the body to recover, and you should maintain a suitable number of sleep hours, at least 8 hours per day, in order for the recovery from the surgery to be faster.
- Follow the precautionary instructions after the operation
It is important to keep the leg raised so that it is at an appropriate level from the heart, using pillows under the heel or foot and not under the knee, and this reduces swelling that may affect the knee after the operation, and an integrated diet rich in important elements must be followed to accelerate the healing process.
- Take the necessary medications after the operation
The patient can start taking painkillers prescribed by the doctor, especially in the first week after the cruciate ligament surgery, to reduce the feeling of pain and swelling, and the patient must take care of the bandage placed on the wound and keep the wound dry and clean so that you do not get infected.
- How to sleep after cruciate ligament surgery
You may wonder about the way to sleep after the cruciate ligament operation, which is important in order not to cause any complications as a result of sleeping incorrectly. The patient can sleep after the cruciate ligament surgery, keeping the knee raised up, and he can use pillows under the foot to give more comfort when sleeping.
Recovery time from cruciate ligament surgery
Determining the duration of recovery or recovery after the cruciate ligament operation is due to the patient’s condition and how he adheres to the instructions of the attending physician, but in general, the person can return to his usual activity after several weeks from 6 to 12 months, and he must take care of physical therapy in order to accelerate the recovery process.
When is the knee bent after cruciate ligament surgery?
Reaching full recovery may require several weeks after the cruciate ligament operation and sometimes up to months until you return to your activity and practice your life and work as before, and the knee can be bent 4 weeks after the operation, and the person should not rush the results in order not to cause harm to the knee unintentionally.
Knee swelling after cruciate ligament surgery
A little swelling can occur in the knee after the cruciate ligament surgery, and it is the result of some fluid gathering around the knee, which is one of the causes of pain that the person feels after the surgery, and the patient must take into account complete rest while raising the leg and applying ice packs in order for the tumor to gradually decrease after several days of the operation.
If the pain increases or the swelling in the knee becomes larger and does not end after a few days of surgery, you must immediately return to the attending physician to detect other causes of knee swelling or add another anti-inflammatory drug in order for the recovery to be faster.
How long does the pain last after cruciate ligament surgery?
There is pain that accompanies the patient after the cruciate ligament operation in the first days, and it begins to gradually decrease in a period of one to two weeks after the surgery, and the pain may be accompanied by swelling or bruising in the knee, but it also diminishes over time with the use of painkillers prescribed by the doctor, especially in the first period after the operation.
Knee flexion after cruciate ligament surgery
In general, the person returning to his normal activity and performing his work normally after the cruciate ligament surgery may need some time for the person to feel the full ability to move the knee and leg without pain or medical supervision, especially since the cruciate ligament is one of the strong ligaments in the body and its recovery may take time.
A month after the operation, the patient can begin to bend the knee to a degree of up to 90 degrees, and he can also start dispensing with the crutch after six months of surgery and start full loading on the knee while maintaining physical therapy throughout the recovery period because it helps things return to normal faster.
It takes several weeks for the capillaries and tissues to return to normal, starting from 10 to 12 weeks, with continuous follow-up of physical therapy, which helps the knee and the rebuilt ligament to function properly again, jogging and other sports that need more effort can be practiced 5 or 6 months after surgery.
How long is physical therapy after cruciate ligament surgery?
There are individual differences from one person to another in the duration of recovery, physical therapy, and return to the normal routine that the person performs, but in general, the duration of physical therapy after cruciate ligament surgery can be from 6 to 12 months, and there is no doubt that rehabilitation systems after cruciate ligament surgery have an effective role in the patient reaching the recovery stage faster.
How many physical therapy sessions after the ligament operation?
The duration of physical therapy after cruciate ligament surgery can last for several weeks or months, depending on the condition of the patient and his response to treatment. The physiotherapist begins his work directly with the patient from the first day after the surgery, and the number of physical therapy sessions per week may reach from 5 to 6 sessions.
Physiotherapy continues with the injured person for a long time until he can fully bend the knee to approximately 110 degrees, and also works to increase muscle strength and gradually load on the knee so that the injured person does not relapse and does not feel complications in the affected part.
How do I know the success of the cruciate ligament operation?
The recovery period from the cruciate ligament operation can be several weeks up to months in some cases, and some signs indicate that the cruciate ligament operation succeeded and the injured person recovered from the tear or cut that affected the ligament, and the signs can be as follows:
- The gradual disappearance of the feeling of pain and swelling of the knee.
- Restore knee movement and return to normal.
- Joint and muscle response to physical therapy and increase their strength.
- The ability to carry out daily activities as efficiently as before.
- The attending physician orders x-rays and tests to ensure that the knee is completely healthy.
Walking after cruciate ligament surgery
The question of when will I walk after the cruciate ligament operation is one of the questions that the patient cares about a lot after the surgery, and the specialist doctor is the first responsible for answering this question because he is aware of the patient’s condition and the development that happened to the knee and ligaments after the operation.
But in general, the cruciate ligament sufferer can walk within two days of the operation for only a few minutes with the help of a physiotherapist, using crutches to reduce swelling in the knee and help in strengthening the muscles.
In the weeks between the third and fourth weeks, the infected person can start walking on his own for a short period without assistance, and at the beginning of the tenth week, he can increase his walking speed and do simple types of exercise.
To answer the question of when can the patient walk after cruciate ligament surgery? It should be mentioned that a person can walk properly and reach the stage of recovery within 6 to 12 months, and the appropriate rehabilitation and physiotherapy program helps him reduce this period slightly.
Symptoms of cruciate ligament failure
Sometimes cruciate ligament patients may experience failure of the operation or a health problem in the knee that affects the person’s recovery and return to his usual activity, and the symptoms of cruciate ligament failure may appear as follows:
- Continuous increase in knee pain despite adherence to the doctor’s instructions and the use of painkillers.
- A feeling of instability in the knee, difficulty in controlling it, and a delay in the person’s recovery.
In this case, the injured person must return to the attending physician as soon as possible in order for the person’s condition to be treated correctly and to exclude the presence of other problems such as knee roughness or inflammation in the joint that affects the patient’s access to recovery.
Knee crepitus after cruciate ligament surgery
Some associate hearing a crackling sound in the knee after cruciate ligament surgery with its failure or a setback for the patient, but hearing a creaking or crackling sound in the knee has many factors, including problems in the joint or the cartilage surrounding it.
Knee crepitus can be a serious matter after cruciate ligament surgery if severe pain occurs with it, great difficulty in moving the knee, sliding of the shin bone, and an imbalance of the person when walking, because in this case, it may be a sign of failure of the cruciate ligament process.
X-rays and magnetic resonance imaging may help to accurately determine the condition of the knee, reach the main cause of the knee cracking, and find out what disease you have, and then the doctor determines the next steps in treatment.
Knee swelling after cruciate ligament surgery
The occurrence of swelling in the knee after the cruciate ligament surgery is normal and is the result of the formation of fluid around the joint as a natural reaction of the body to the surgery, and usually, the swelling or swelling around the knee gradually decreases in the first weeks of the operation by using cold water compresses and walking for a few minutes daily.
It is not necessary that the swelling of the knee be one of the signs of the failure of the cruciate ligament operation, but there is more than one other reason, including infiltration in the joint or inflammation that affected this part and others, and returning to the specialist doctor if the symptoms of swelling increased and continued for a long time is the right thing to do in order to work on determining the main cause of the swelling and its treatment.
Can a soccer player return after cutting the cruciate ligament?
Football players may think that cruciate ligament injury is the end of their career in the stadiums, but this contradicts the proven scientific facts that more than 80% of cruciate ligament injuries were able to return to their normal activity and work well as before.
It is noteworthy that several players were able to play football with a cut in the cruciate ligament, including Zlatan Ibrahimovic, a player of the Italian club AC Milan, and some doctors stated that the presence of a partial cut in the cruciate ligament in some strong sports practitioners may not constitute a major obstacle to the practice of their work well.
But neglecting the treatment of cutting the cruciate ligament may cause greater health problems in the knee and the cartilage in it, so to refer to the attending physician and start treatment, whether conservative or surgical, while following up the process of rehabilitation and physical therapy is an important matter that contributes greatly to the return of the injured person to his full fitness.
