Anterior cruciate ligament tear; VM Medical Park Ankara Hospital Orthopedics and Traumatology Specialist Op. Dr. Mahmut Özdemir warned about what to do in anterior cruciate ligament injuries.
Kiss. Dr. Mahmut Özdemir, “Anterior cruciate ligament; It is a structure located between the femur and tibia bones, also known as the thigh and tibia, preventing the knee from slipping forward and providing cyclic support.
VM Medical Park Ankara Hospital Orthopedics and Traumatology Specialist Op. Dr. Mahmut Özdemir said that tears due to wear can also be seen in the advanced age group due to the change in ligament mechanics.
Kiss. Dr. Mahmut Özdemir said, “Apart from sports injuries, anterior cruciate ligament tear can also be seen in situations such as direct trauma, work accidents, traffic accidents, and falling from a height. In addition to these, in children, it can also be seen in the form of breaking the bone tissue to which the ligament is attached.
PAIN AND Swelling RESTRICT KNEE MOVEMENT
Stating that sudden tears usually show themselves with a breaking sound and deep pain, Op. Dr. Özdemir later stated that the majority of the patients had swelling due to intra-knee bleeding. Kiss. Dr. Özdemir said, “Pain and swelling after a tear causes movement restriction in the knee. In the following days, swelling and pain decrease. Patients can return to their normal lives, but the feeling of stepping on the empty space, the feeling of insecurity when making sudden turns and descending the stairs, and the feeling that the tibia is slipping under the thighbone can be seen.
MRI IMAGES HELP DIAGNOSIS
Stating that the sound of breaking off as a result of trauma and the development of pain and swelling after trauma are typical findings, Op. Dr. Özdemir shared the following information about how anterior cruciate ligament injury can be diagnosed:
“The patient needs to be carefully examined. Almost all patients can be easily diagnosed with history and examination. Magnetic resonance imaging (MRI) is used in clinically suspicious cases. In an anterior cruciate ligament injury, the continuity of the ligament may appear to be preserved on MRI, even though the ligament has been injured to such an extent that it cannot function. On the other hand, an unbroken bond may give a signal as if it were broken due to widespread payment. For this reason, the history of the injury, physical examination findings and MR images should be evaluated together in anterior cruciate ligament injuries.
TREATMENT IS DONE ACCORDING TO THE AGE OF THE PATIENT
Saying that the treatment may vary according to the age, expectation and activity level of the patient, Op. Dr. Özdemir said, “After an anterior cruciate ligament injury, it is not possible to perform at a high level, especially in sports such as football, volleyball, basketball, where movements such as sudden turns, jumps and acceleration are frequent. Therefore, we recommend surgical treatment for anterior cruciate ligament injuries, especially in young and active patients. Today, due to factors such as the prolongation of life expectancy, advances in implant technology and developments in surgical techniques, and an increase in activity expectation, surgical applications can also be applied to patients over 40 years of age.
THE BELIEF THAT HE CANNOT GO AGAIN IS WRONG
Stating that the tendons taken from the patient are generally used in adult anterior cruciate ligament repairs, Op. Dr. Özdemir stated that a new anterior cruciate ligament was formed with the tendons passed through the tunnels opened in the knee joint of the thigh and shin bone. Kiss. Dr. Özdemir underlined that this procedure is performed completely closed with the help of arthroscopy.
Emphasizing that the recent developments in medicine and technology, the success rate after anterior cruciate ligament repair has increased up to 90 percent, Op. Dr. Ozdemir said:
“The classic thing is that a professional athlete who has had anterior cruciate ligament surgery cannot regain his former performance. However, we strongly disagree with this view. With a special technique we apply in our clinic, we can apply a thicker and stronger tendon to our patients in a shorter time compared to the traditional method, while preserving the bone stock. Again, we can start the rehabilitation process more quickly compared to the old method. In this technique, we perform all operations in the joint with specially designed tunnel openers. We do not need additional implants such as screws or U-nails to fix the tendon graft. Since we can fold the graft (tissue patch) we receive from the patient more, we can obtain a thicker tendon graft from the same tendon. On the other hand, thanks to its special mechanism, we can apply a double-sided balanced stretching process to the new ligament we have placed.”
POST-SURGERY PHYSIOTHERAPY IS IMPORTANT
Stating that patients can walk without support if only anterior cruciate ligament surgery has been performed, Op. Dr. Mahmut Özdemir emphasized that various knee pads can be given to patients after the surgery, but they do not use any knee pads or additional apparatus in their clinics.
Kiss. Dr. Mahmut Özdemir said, “Patients are discharged on the first day after surgery if they do not have any additional problems. Our goal at discharge is to have a patient who has no wound problems, whose pain has decreased to a controllable level, who can bend the knee 90 degrees, and who has no additional problems. In the third week after the surgery, we start the physical therapy program.”
Kiss. Dr. Özdemir said, “If the surgery was performed with the correct technique and flawlessly, if the physiotherapy process was strictly followed in the post-operative period, the probability of rupture at the end of a one-year period is as good as the healthy side. In addition, I would like to point out that we do not expect any decrease in performance after this surgical treatment in an athlete.”
YOU CAN RETURN TO SPORTS AFTER 6 MONTHS
Emphasizing that if the cartilage or meniscus is not treated, it will be okay for patients to walk, Op. Dr. Özdemir said, “Still, we recommend using crutches for a few weeks after the surgery to reduce the risk of falling and prevent overloading. After the rehabilitation process, we allow our patients to return to sports at the end of 6 months from the date of surgery.”
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