One of the most common injuries to the knee in young and older athletes is a tear or rupture of the anterior cruciate ligament. This ligament is the most stabilising ligament of the knee joint and once torn it is usually impossible or very difficult to undertake most sporting activities which require running, sudden change in direction and stopping quickly.
If one attempts to play sport with a knee that has a torn anterior cruciate ligament, the knee usually gives way, swells, often is painful and the chances of further injury (such as tearing cartilages) is very high.
Reconstructive surgery can restabilise the knee and allow a return to all sporting activities undertaken prior to the injury.
- Athletes who wish to continue playing sport
- Any patient whose knee “gives way” on a regular basis
- Young, high demand athletes
Candidates for Reconstructive Surgery
In most cases a diagnosis is usually made from the clinical history and examination. This can often be aided with the use of an xray and/or an MRI scan.
The anterior cruciate ligament, once torn, does not heal and cannot be repaired. It is usually repaired by grafts taken from around the knee, or more recently using a synthetic graft.
Grafts are taken from:
- Patella (or kneecap) tendon
- Hamstring tendons
- Synthetic ligament or LARS
Whatever the graft, they are inserted into the knee by drilling holes through the tibia (shin bone) and femur (thigh bone) and are fixed inside the tunnels by screws or pins.
Using the synthetic LARS ligament will allow a very rapid rehabilitation, recovery and ultimately a quick return to sport. Often returning to normal sporting activities within three to four months, whereas with hamstrings or patellar tendon grafts the usual timeframe is nine to 12 months.
Not all patients will be able to have the LARS reconstruction and your surgeon will discuss with you if it is appropriate for your injured knee.
Following the surgery you will spend one or two days in hospital undertaking early rehabilitation. This involves:
- Pain relief and regular ice packs to the knee
- Use of a continuous passive motion (CPM) machine which slowly moves your knee back and forth to help regain motion
- Crutches for one to two weeks
- Physiotherapy to regain muscle strength and movement of the knee, and agility exercises
- Knee brace – usually with hamstring reconstructions
You can return to sedentary or seated type jobs after three to four weeks but more physically demanding jobs may require three months.
Return to full sporting activities will be nine to 12 months.
If a LARS ligament is used, then return to physically demanding jobs could occur within four to six weeks, and return to sport in three to four months.