Therapy & Investigation
Disease: High-energy traumas may tear stabilizing ligaments of the knee. The most frequent injuries are those of the internal collateral and anterior cruciate ligament. The cruciate ligaments may tear as a result of injuries of twisting mechanism, usually while playing football, skiing, playing basketball or handball.
Symptoms: Patients feel a sharp pain at the moment of injury, their knee becomes swollen and unstable (baggy), and some types of movement are no longer feasible (squatting, running). If the tear of the ligament occurs in parallel with injury of the meniscus, the semi-lunar cartilage may split, resulting in joint lock.
Treatment:Depending on the circumstances and location of the injury and the compliance of the patient, the symptoms may be so acute that they require urgent intervention (joint lock or completely unstable knee), or surgery may conceivably be postponed for weeks or even months.
There are two methods of surgical treatment for injuries of the collateral ligament. The knee joint will be rinsed via arthroscopy (with a fiberscope), the semi-lunar cartilages and the integrity of the joint surfaces will be examined, torn cartilaginous fragments will be removed; if feasible, ligaments will be fixed with sutures (for detailed description see sub-chapter "Surgery").
In many cases, tears of the anterior and posterior cruciate ligament require reconstruction, performed by means of autologous tendon transplantation.
Surgery is performed with an arthroscopic technique. The replaced ligament completely incorporates into the bones, substituting the function of the torn cruciate ligament. The absence of the removed tendon causes no alteration in behavior when compared to that of the intact knee.
I routinely apply the two-channel, anatomical technique for the replacement of the anterior cruciate ligament.