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Ligament Reconstruction

Ligament Reconstruction

Top Doctors
Top Doctors editorial
Top Doctors
Created by: Top Doctors editorial
Edited by: TOP DOCTORS® at 26/06/2020

To understand something about Ligament Reconstruction, one must first talk about Joint Stability, of which there are three types:


1- Primary Stability: That given by the intrinsic form of the Joint. In this way there are profiles that fit as a key in your lock, such as the Hip Joint, where on one side is the Ball-shaped Head of the Femur and on the other, a cavity in the Pelvis. This type of joint has an excellent level of stability of its own


2- Secondary Stability: It is when the Knee does not have an anatomical structure that favors stability. It is given by the Ligaments that unite both bones, the Tibia and the Femur. In case these fail, the Knee will present an instability that will hinder the function, especially in activities that require jogging with changes of direction, a situation that is observed, for example, in soccer and basketball. This is why, in the face of proven instability both in daily life and with laboratory tests, Reconstruction of those Injured Ligaments is required. However, not all people require Surgery, so Reconstruction is recommended in those whose physical activity is demanding or that joint stability is constantly tested.


3- Tertiary Stability: It is recommended in those patients over 55 years old and with sedentary activity. In those who the risk of instability is not a problem, it is indicated to reinforce the musculature, since, maintaining an adequate power, especially of the Anterior and Posterior Thigh, it is possible to maintain a normal life. However, this must be weighed applied to each particular case, because there are a diversity of people with different requirements


Advanced Osteoarthritis is considered a formal contraindication for Knee Ligament Reconstruction and will only apply to very specific cases.


Surgical process

Regarding the surgical technique, an element is required that allows performing the same function that the injured ligament had, for example, in the case of the Crusaders, Anterior or Posterior, these structures are not repairable, so it must be replaced with a Tendon Graft, which can be obtained from the same patient or from a cadaver donor.


The Specialists prefer that the Graft be their own, since there will be less chance of failure as it is a structure obtained at the time, because it contains living cells and with this, less chance of rejection. This graft is self-transplanted to the Knee and a fixation system is performed with screws or suspensory methods.


Post-surgical treatment requires a relative rest time, one or two days of hospitalization with the start of Early Kinesiotherapy that includes a lot of exercise and muscle development.


The reinstatement will depend on the requirement on the Knee. For example, a construction worker with high physical demand should take at least 6 months to resume his normal full activity. Whereas, an office worker, depending on his conditions, could evaluate the labor discharge one month postoperatively. However, all this is relative and the treatment must be adapted in a personalized way.


In relation to sport, kinesiological work specific to your activity should be started, progressive and personalized. In general, "court work" is recommended with adequate evolution, with a change of direction after approximately 6 months of light sports activity at 8 months and a full competitive return one year after surgery.


The patient will be obliged to maintain constant muscular work throughout his life in order to provide adequate tertiary stability and not to overly demand the reconstructed ligaments.

Traumatology and Orthopedics