Anterior cruciate ligament injury in the left knee. 20

The plaster cast for a complete break is not very effective, and the knee joint is stiff after three weeks of fixation, and of course it cannot be bent. It is still the operation, the wear and tear of the knee joint will be more serious after a long time, and there will be sequelae in the future.

Arthroscopic surgery is now very mature and can be repaired with arthroscopic repair with a surgical incision about 1cm long on the medial and lateral sides of the knee joint to reconstruct the anterior cruciate ligament and repair the posterior cruciate ligament. Reconstruction can be autologous or allogeneic.

I am an orthopedic surgeon, I once injured the ACL, completely ruptured, and the ACL reconstruction was done in our hospital more than 3 years after the injury, and I walked on the third day after the injury, and the knee joint returned to its previous function in 1 month. It takes 1 and a half years to heal completely.

If you need to, you can communicate with me, and I hope you can give you more ideal suggestions.

If the anterior cruciate ligament rupture of the knee does not heal on its own, the only way to do it is to undergo arthroscopic ligament reconstruction surgery. If there is no surgery, the knee joint will be habitually sprained, and a series of side damage will occur, so surgery must be done. This is a very mature operation, as long as it is carried out in a regular place, such as the Third Hospital of Beijing Medical University and Jishuitan Hospital in Beijing.

Recovery time after surgery takes months, and it takes at least 1 year to get back to playing basketball vigorously.

I went to the hospital for anterior cruciate ligament reconstruction, and walked on the third day after surgery, and the knee joint regained its previous function in one month. It takes 1 and a half years to heal completely. Go to a big hospital.

When exercising, due to our inadequate movements or mistakes, it is easy to cause injury to the knee joint, and if we do not take timely measures, then the knee cruciate ligament is very likely to have sequelae. Symptoms such as lower limb and joint weakness are left by ligament damage, so we should take some measures to prevent and treat ligament injuries. <>

The cruciate ligament is usually located in the knee joint, and if the joint is unstable for a long time, it can cause damage to other joints or structures in the knee. For example, if the cartilage and meniscus in the joint are damaged, if the ligament is moderately damaged, it may also lead to the symptoms of ligament relaxation and instability. Such serious sequelae also need to be paid close attention to, so in the face of such symptoms, we also need to judge the location of the ligament injury, and then take the method of surgery.

Usually, if the anterior cruciate ligament is damaged, the patient needs to undergo ligament reconstruction surgery immediately, because the damage to this area often results in the rupture of the ligament. Therefore, the impact on joint function is very large, and the abnormal time can also cause meniscus damage. In addition, if the posterior cruciate ligament is damaged, then it needs to be dealt with on a case-by-case basis.

In general, this symptom is usually divided into other and simple ligament injuries. In the case of simple ligament injury, it is usually only necessary to observe in time, wear a nursing brace, and then exercise to achieve a good balance of muscles, and then evaluate through a period of observation, and then take a conservative method. However, if the ligament strain is more than one centimeter offset, then surgery is required**, and this surgery is usually a reconstruction of the ligament**, so after the ligament is damaged, it is necessary to go to the hospital in time and treat the combined injury under the examination of a professional doctor.

If the cruciate ligament injury is not carried out early and active, there may be sequelae symptoms: 1. Weakness of the joints and lower limbs, due to ligament injury, the stability of the knee joint is relatively poor, and the weakness of the knee joint can occur at that time, and at the same time, the obvious weakness when walking in the lower limbs, and the inability to walk or run quickly can seriously affect life and not be able to play sports. 2. Knee joint instability, posterior knee instability can occur after cruciate ligament injury, and then when walking briskly or going up and down stairs, there can be a sense of knee joint dislocation, resulting in knee joint instability.

3. If the cruciate ligament injury surgery is performed, many patients may have related sequelae symptoms after surgery, such as limited joint movement, some patients may have limited function of joint flexion and extension, and can also have sequelae caused by complications such as postoperative infection and thrombosis of the lower limbs.

1.Plaster fixation after injury or cruciate ligament reconstruction surgery after plaster fixation is easy to cause adhesions around the joint due to the long fixation time, which affects the normal movement of the joint. In particular, there are many patients who are afraid of pain during the exercise process, which will lead to serious adhesions.

2.Because the knee joint is less active after the injury, it may also cause the surrounding muscles and soft tissues to atrophy, which can easily lead to a decrease in the normal joint movement strength, so it also has a certain impact on the normal movement of the knee joint.

3.Due to local injuries or aseptic inflammatory lesions left after surgery, it is easy to have pain in the knee joint during exertion and cold. 59 01:

28 How Posterior Cruciate Ligament Injuries Are Caused Posterior cruciate ligament injuries are more forceful than anterior cruciate ligament injuries.

What to do about a knee cruciate ligament injury? Are there any sequelae after a knee cruciate ligament injury? Anterior and posterior cruciate ligament injuries to the knee are often caused by severe trauma, such as the impact of a heavy object.

For sequelae after ligament injury or not, it mainly depends on the degree of positive activity of the patient.

MR examination of the knee joint can directly show the injury or rupture of the anterior cruciate ligament, which can be used as the primary basis for the diagnosis of knee MRI

1. Anterior tibial displacement (anterior drawer sign).

In previous issues, we discussed the anterior cruciate ligament, the main role of ACL is to maintain the stability of the knee joint and prevent the tibia from moving forward, so when the ACL structure and function are dysfunctional, the tibia will move anteriorly.

A distance of more than 5mm from the posterior edge of the tibia in the middle layer of the sagittal plane of the knee can be used as an indicator of anterior tibial displacement (anterior cruciate ligament rupture).

2. PCL bow bending.

The anterior cruciate ligament prevents the tibia from moving anteriorly, the posterior cruciate ligament prevents the tibia from moving backward, and when the anterior cruciate ligament ruptures, the posterior cruciate ligament will appear lax, the tension will be weakened, and the PCL will be arched.

The image above shows that the posterior cruciate ligament is lax, angulated, and the ratio of A to B increases.

3. Bone contusion.

ACL rupture loses its effect of preventing the tibia from moving anteriorly, and the lateral femoral condyle and the posterior tibial plateau will directly rub and impact, and at this time, there will be a subtle fracture called bone contusion, microhemorrhage, bone marrow edema inside the bone, this injury is called a "kissing contusion", but young people with stretch ligaments are not necessarily ACL rupture if they have the above manifestations. In addition, this contusion can lead to deep indentation of the lateral femoral condyle.

Patchy hyperintense shadows can be seen behind the lateral femoral condyle and tibial plateau, which is one of the secondary manifestations of anterior cruciate ligament rupture, and the articular surface of the lateral femoral condyle cartilage forms an arc-shaped indentation, and the articular cartilage is locally defected.

Fourth, segond fracture.

Small avulsion fractures on the lateral tibial plateau of the lateral capsule, 100% with anterior cruciate ligament rupture and injury. It is usually caused by internal rotation and varus of the lower leg, which causes the lateral capsular ligament (including the posterior fibers of the iliotibial band and the anterior oblique fibers of the lateral collateral ligament) to be subjected to strong traction.

X-ray shows an abnormal density of small fragments lateral to the tibial plateau of the knee.

MRI coronal view shows a small patchy avulsion fracture lateral to the tibial plateau of the knee, thickened anterior cruciate ligament, elevated internal signal, and tortuous walking. Segond fracture.

5. Dorsal injury to the medial tibial plateau includes a tear at the attachment of the semimembranosus tendon.

1. Front drawer sign (outer >5mm).

2. PCL bow bending;

3. Bone contusion: lateral femoral condyle and posterolateral tibial plateau;

4. Segond fracture;

5. Avulsion fracture of the attachment of the semimembranous tendon.

Hello, a partial injury to the anterior cruciate ligament in young patients can be considered non-surgical**, i.e., brace or cast fixation with knee extension or knee flexion at 30° for 3-6 weeks, and start knee range of motion exercises and muscle strength training; If the injury is complete, I recommend arthroscopic ligament reconstruction surgery to prevent many sequelae in the future. After a period of immobilization, your symptoms may be relieved, but there is a good chance that there will be sequelae. If there is swelling in the knee joint, you can put two pillows under the calf and put it a little higher when resting; Ligament strains are generally not contraindicated.

It is recommended that you come to our clinic for a detailed examination to see if the joint is stable and whether there are any other injuries, and please bring the MRI** and other examination materials when you come.

Wang Zimin, Shanghai Changhai Hospital.

In terms of differential diagnosis, the disease needs to be distinguished from the following two diseases:

1.Medial collateral ligament injury.

In addition to the lateral stabilizing effect of the knee joint, it also has the function of fixing the meniscus and controlling the movement of the knee joint. The medial side of the knee will be swollen and painful, and when the medial collateral ligament rupture part is lightly pressed, it will feel traumatic, if the injury is severe, the knee will lack a sense of stability, and shake instability, sometimes there will be blood accumulation, when the collateral ligament is injured, you can first lift the affected part to a higher part than the heart, and apply a cold wet cloth to the affected area lightly, so that the swelling is reduced to a minimum, if the symptoms are mild, you can use elastic bandage, etc., to fix the affected part, first with a cold wet cloth and then change to a warm wet cloth method, after two to three weeks of local fixation, within the scope of the affected part will not be painful, If the ligament is completely ruptured, it is necessary to undergo the operation of a specialist to suture the ruptured ligament, regardless of minor or serious injury, and do not forget to add knee braces and other equipment when exercising after the accident.

2.Upper tibial protrusion.

The symptoms of this disease are usually caused by excessive pressure on the knee such as frog jumping, and the bone is often caused by the fact that the bone does not grow as well as the muscles or tendons, and is often caused by the growth of the muscles or tendons. Due to the tension of the ligaments, the tibia protrusion at the upper end of the front tibia is visible, and the bulge of the bone is visible, and when you press it with your hand, it will have a dull pain, and it is the same as the sports knee caused by the uncontrolled running or jumping. People with O-leg or X-shaped legs are also believed to have heavier knees than normal people, so they are prone to this disease, and the training to hold one hand against the wall to support the body, and the other hand to grasp the same foot and pull it back, so that the four tendons of the thigh can be straightened by the force of the backward traction of the flexed knee joint, which is a good way to prevent this disease.