Knee Ligament Reconstruction
The knee is an amazingly complex joint, formed by the articulation between the thigh bone (femur) and the shinbone (tibia). These bones are held together by four strong ‘rope-like’ structures called ligaments. The knee has four major ligaments – the anterior cruciate ligament, posterior cruciate ligament, lateral collateral ligament, and medial collateral ligament . Two collateral ligaments are present on the sides of the knee and control the side-to-side movement of the knee. The anterior and posterior cruciate ligaments which are present in the centre of the knee joint control the back and forth movement of the knee.
Knee ligament injuries are common in athletes involved in contact sports such as football and rugby. They are also common in sports such as netball and other activities such as dancing. Ligament injuries can occur as a result of major trauma such as a direct blow to the knee, or a fall from height or road traffic collision. Patients with knee ligament injuries may experience instability, pain, swelling, limited range of motion, mechanical features and even injuries to nerves/arteries of the leg.
Knee ligament injuries are graded based on the severity of injury. In grade I injuries, the ligament is mildly damaged and slightly stretched, but the knee joint is stable. In grade II injuries, there is a partial tear of the ligament. In grade III injuries, there is a complete tear of the ligament and the ligament is divided into two halves making the knee joint unstable.
Some knee ligament injuries require surgery to reconstruct the ligaments. Reconstruction of the torn ligaments using a tissue graft taken from another part of the body, or from a donor is known as ligament reconstruction. The damaged ligament is replaced by the graft and fixed to the femur and tibia using mechanical devices such as screws/clips/staples. Gradually, over a period of a few months, the graft heals inside the knee.
Surgical reconstruction is usually performed arthroscopically (keyhole surgery). Arthroscopic reconstruction of the knee ligament is a minimally invasive surgical procedure performed through a few small incisions. An arthroscope is inserted into the knee joint through one of the small incisions to provide clear images of the surgical area (inside the knee) to your surgeon on a television monitor. Guided by these images, your surgeon at the ‘The Cambridge Knee’ performs the surgery using small surgical instruments inserted through the other small incisions around the knee. As the surgery can be performed through smaller incisions it provides the following benefits:
- Less post-operative pain
- Shorter hospital stay
- Quicker recovery.
Following arthroscopic reconstruction of the injured ligament, most athletes will have the aim of a return to sport after a period of rehabilitation.