Cruciate Ligament Reconstruction
The anterior cruciate ligament is one of the two ligaments that cross the center of the knee connecting the thigh bone with the tibia and contributing to the stability of the knee joint.
Injuries to this ligament occur mainly when practicing sports and physical activity due to the pressure exerted on the knee.
Some examples of movements which may cause these injuries are:
- Reducing speed and changing direction suddenly.
- Turning with the foot planted on the ground.
- Landing inappropriately from a jump.
- Stopping suddenly.
- Receiving a direct impact on the knee.
Treatment
Depending on the type of patient and injury, there are surgical and non-surgical treatment options. An anterior cruciate ligament injury may be treated satisfactorily with physical therapy in relatively inactive people, people who participate in recreational activities and moderate exercise, including sports that exert less pressure on the knee. Surgical treatment consists of reconstructing the anterior cruciate ligament. Since ligaments are strong tissue bands connecting one bone to another, during reconstruction, the broken ligament is removed and replaced with a tissue band connecting the muscle with the bone (tendon). The graft tendon is extracted from another part of the knee or the body. Cruciate ligament reconstruction is usually recommended in the following cases:- When patients are athletes.
- When more than one ligament is damaged.
- When the torn meniscus requires repair.
- In cases when the injury causes the knee to fail or give out during everyday activities.
- When patients are young (considering other factors such as activity levels and knee instability, which are more relevant than age).
Meniscus Repair
A meniscus is a C-shaped piece of resistant, rubbery tissue that acts as a shock absorber between the tibia and the femur.
The meniscus tear is one of the most common knee injuries, since it could be caused by any activity that causes the knee to turn or twist forcefully or suddenly, especially, when resting all the weight on it. Even actions like kneeling, squatting or lifting heavy objects could cause a meniscus tear.
Symptoms
A torn meniscus causes the following:- A popping sensation
- Swelling or stiffness
- Pain, especially when twisting or turning the knee
- Difficulty straightening the knee completely
- Feeling like the knee is stuck when trying to move it
- Feeling like the knee buckles
Treatment
There are conservative treatments for this injury, such as prescribing rest, applying ice or administering medication. However, some cases require a surgical procedure to repair the torn meniscus. Learn more about Fergus’ products for meniscus repair: CordFit Meniscal Repair, Needle with loop and Meniscal sheaths.
Extracapsular Knee Injuries
Extracapsular injuries affect the structures that provide stability to the knee and are located outside the joint. An appropriate diagnosis and treatment is key to prevent chronic instability and ligament reconstruction failure.
Medial patellofemoral ligament (MPFL)
This is the main static stabilizer of the patella against lateral displacement (up to 50%). MPFL reconstruction is the most widely accepted treatment in cases of recurrent patellar instability.- Indication: patients with repeated luxation episodes or patients suffering their first luxation with an associated injury or free bodies.
- Technique: double-bundle reconstruction or patellar tunnel technique, using anchors, buttons (Tenz) or interference screws for fixation.
Lateral extra-articular tenodesis (LET)
A complementary process to improve the rotational stability of the knee. Indicated for:- Chronic ACL ruptures or revisions with a marked pivot shift
- Acute ACL injuries in hyperlax athletes