Rupture of the knee cruciate ligament - Causes, Symptoms and Treatment .MF .
Cross (cruciate) ligaments are located in the knee joint cavity.Anterior cruciate ligament is attached on one side to the hip bone rear projection passes through the joint cavity and joins the other hand to the front of the fovea of the tibia.Anterior cruciate ligament fixes the joint, preventing severe anteversion shin.The rear cruciate ligament connects the lateral surface of the condyle with zadnemyschelkovoy fossa of the tibia, and passing through the joint of the knee joint and the locking preventing the displacement of the tibia in the direction of "backward."
Damage anterior cruciate ligament occur with the greatest frequency due to the impact forces in the direction towards the back of the knee joint when bent inward and the lower leg.Most cruciate ligament ruptures are caused by sudden fast movements in the knee joint.
gap cruciate ligament
main causes of rupture of knee ligaments are:
• a force on the thigh or lower leg;
• sudden braking;
• landing from a height on straightened leg
rupture Symptoms of knee ligament
breaks the knee cruciate ligaments are three degrees:
• first degree: tissue cruciate ligament occurred micro-breaks.At the same time there is pain in the knee, the mobility is limited and there is a slight swelling.
• second degree : symptoms are similar as in the case of a small gap, but if such an injury was the place to be for once, more often it is repeated.The consequence is a decrease in tissue elasticity, wear ligaments.Secondary trauma can occur during normal rotation of the legs.
• third degree: most dangerous, as it is a complete rupture cruciate ligament, it is accompanied by pain and limited movement.The joint becomes highly unstable, impaired limb function support.
often happen to "combine" breaks.The most dangerous injury is considered to be a gap of two cruciate ligaments, the two lateral ligaments and joint capsule itself.Because of this, there is the extreme instability of the joint and to the complete loss of the support of the affected limb.
Symptoms of rupture of the knee cruciate ligaments are:
• soreness • swelling
• restriction of movement in the knee
• symptom of "balloting" patella
• instability, "looseness" of the joint.
• symptom of "drawer".
Often the knee cruciate ligament rupture of the symptoms are similar to symptoms of other knee injuries, such as injury, damage to the meniscus sprain, dislocation of the patella. Therefore, when these symptoms it is important to consult a physician for proper diagnosis and treatment.
First aid at knee ligament rupture
First aid in fracture of the knee cruciate ligament lies in the fact that the victim give anaesthetising ensured peace on the damaged joint is applied ice the knee is fixed and is lifted.
victim must be delivered to the clinic.If this is not possible, in the first days after injury victim should limit any movement of an injured leg, to avoid further damage to articular ligaments.In the first twenty-four hours should be used cryotherapy - apply to the affected area, ice or cold packs.This helps to reduce bleeding in tissue.
should splint, bandage or wrap the limb with an elastic bandage.When severe pain to the patient should take a non-steroidal painkillers.In no case can not warm the injury site, it is prohibited "to reduce a" knee.
Diagnostics knee ligament rupture
The following methods of diagnosing rupture of the knee cruciate ligament:
• Talk with the patient in order to clarify the circumstances obtaining
injury • reception "drawer".For diagnostic purposes, ruptures cruciate ligaments doctor tries to move the affected tibia anteriorly or backward.In case of rupture of the anterior cruciate ligament tibia strongly shifted forward.In the case of the rear cruciate ligament rupture shin effortlessly moves posteriorly.If there was a break for a long time - a symptom of "drawer" becomes blurred due to development near the site of the fatty subcutaneous tissue damage, stabilizing the knee.
• Arthroscopy - joints inspected from the inside with a probe
• CT and MRI (rarely used because of the high cost)
X-ray: the gap cruciate ligament
Therapies tears of the knee cruciate ligament
Treatment begins with a puncture injured joint in order to remove the blood fluid from the joint capsule.Doctor leads in place novocaine damage.Then, making sure that the motor function of the joint is not broken, and the meniscus is not damaged, slightly bent at the knee mobilized limb plaster cast for up to one month.
stationary monitoring is not required.After the plaster will be removed, the doctor prescribes physical therapy, massage and physiotherapy.Immediately after injury surgery is not performed because of the risk of complications.In the case of fracture of the bone fragment and its displacement, surgery is performed urgently.
Thus, conservative treatment gap knee ligaments include:
edema • mobilization
of surgical treatment of cruciate ligament of the knee
Indications for surgery on cruciate ligament is the "looseness" of the joint and the inability painlessmovement relying on the injured limb.The operation is carried out after 5-6 weeks after injury.Bundles are not stapled, because it does not lead to a positive sustainable outcome.Held plastic recovery using a portion of the knee-ligament.In some cases, joint replacement ligament is made of artificial materials.
For optimal outcome of surgery to rebuild ligaments, choose: graft suitable strength and stiffness, correctly position and fix the transplant.As a transplant surgeon uses:
• autografts from the knee-ligament
• grafts from a hamstring
• allografts (donor)
lifetime of artificial ligaments is limited.
In the case of the appointment of surgical treatment, the patient is placed in a hospital, usually for a period of two weeks.
rehabilitation period after surgery
transplant cruciate ligament has the highest strength at the time of the transplant process.Therefore, the main task of the surgeon - providing early joint mobilization and prevention of joint "weakness."This object is achieved by optimal fixation transplanted tissue.
necessary during the week to limit any material impact on the knee joint, it is necessary to use crutches.The load should be increased gradually, this should be done in conjunction with physiotherapy.The first three to five days a damaged leg should always be in the raised position.Physical therapy should be combined with regular lymphatic drainage.
Thanks conducted clinical experiments, we know that a moderate load on the knee promotes the best healing of the graft, as in this case the formation of new collagen fibers, providing strength and elasticity of tissues.Thus, today, doctors prefer the active rehabilitation period will be special physical exercises that are specifically designed for the resumption of the functioning of the knee joint after ruptures cruciate ligaments.
postoperative period suggests gymnastics, which has a positive effect on the strengthening of the graft.Recommended practice:
• poluprisede inclined
housing • a variety of exercises for the legs schadaschie
• moderate walking
forecast after tearing knee ligaments
term disability at break cruciate ligament is about 2 weeks.Patients who engaged in physical labor, can return to work after 4-6 weeks.
If poeratsii in six - eight weeks after the surgery the patient can begin the exercise, such as swimming, walking, cycling, etc.
patients is not recommended to engage in sports actively for six months..after operation.Sport recommended to engage in only a year later.
Ed.doctor traumatologist Savchenko VR