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Knee Ligament Repair (ACL & PCL)

Knee ligament repair or ligamentoplasty is a minimally invasive technique that makes it possible to repair the anterior cruciate ligament (ACL) and/or the posterior cruciate ligament (PCL). This problem is generally suffered by young, active patients who have had an accident, usually while doing sport, and on other occasions.

Benefits of the Operation

This technique or set of techniques has become the standard treatment for knee ligament problems. It is progressing all the time. These techniques make it possible to repair patients' ligament injuries so they can go back to doing sport.

Medical-technical description

Knee ligament injuries can be treated by knee arthroscopy, meaning only very small incisions are required. There are several techniques used to repair this type of injury, according to the origin of the graft to be used to replace the ruptured ligament, as well as different methods for fixing this graft into the knee bone. The ligaments most commonly repaired with these techniques are the anterior and posterior cruciate ligaments.

Although the majority of the surgery involves the use of arthroscopic techniques (through two incisions around the knee), an additional incision is often required through which the tendons are removed and to create the graft that will replace the torn ligament. The materials used to fix the grafts to the bone are biocompatible and do not need to be removed, unless there are complications.

About the operation

Knee ligamentoplasty takes place in the operating theatre, and generally requires a tourniquet or blood pressure cuff around the thigh. Spinal anaesthesia (usually an epidural) is often used in these cases, for a more comfortable post-operative period and far less pain than experienced with conventional knee surgery.

The procedure usually takes about 60 minutes. Patients usually spend a night in hospital and are able to go home the following day. On release, they are given a release report setting out the recommendations, treatment to follow and subsequent appointments.


 

Before the operation

  • The patient goes to the doctor's office for a prior consultation, decisions are taken and the doctor explains the surgery in detail and gives the patient an informed consent.
  • You must take a list of all the medications you use (including medicinal plants) to the hospital with you on the day of your surgery.
  • You will have pre-surgical tests consisting of a full blood test, biochemistry, coagulation, chest x-ray and ECG.
  • You must wash the surgical site with antiseptic soap on the night the day before and on the morning of the surgery. If you wish, you can shave the knee and half way up your thigh at home on the day before the operation.
  • You must obtain two crutches or walking sticks, because you will need these for a few weeks after the operation.
  • If you are to have your surgery in the morning, you must not eat or drink anything that morning. If the surgery is to take place in the afternoon, have an early breakfast then do not eat or drink anything after 9 am.
  • You must remove all metal objects during the operation (rings, bracelets, earrings, body piercings, etc.).

Post-operative care

  • For the first days after the surgery you may suffer some discomfort or swelling, which will disappear when you take the medicine prescribed by the surgeon.
  • A compression bandage will be applied. You must leave this on until you go to have the wound dressed for the first time. After your surgery you will need to wear an elastic compression bandage to the thigh for the next four months. Sometimes the surgeon may tell you to wear a knee support to stabilise the knee.
  • Correct rehabilitation is necessary, so on the first few days you must not travel or do any strenuous or violent movements.
  • You will start moving on the day after the operation. Unless your surgeon tells you otherwise, you will be able to walk immediately, although it is advisable to walk with the aid of two walking sticks or crutches.
  • On release, you will be given a set of exercises to do at home every day.
  • You will receive anti-clotting and antibiotic treatment while you are in hospital.
  • After you are released, you should contact us if you suffer from chest pain or have breathing difficulties, swelling or reddening in one of your legs, sharp pain in the knee on which you have had the surgery, fever or shivering.

The importance of immediate rehabilitation

  • Correct rehabilitation is essential after an operation of this type. Rehabilitation should start as soon as possible and on the first few days you must not travel or do any strenuous or violent movements. That is why we recommend that before you go back to your country you should spend at least eight days doing rehabilitation at our Casaverde rehabilitation centre.
  • This will help you to improve muscle tone and for the muscles affected by the surgery to gradually become stronger, which will reduce the risk of falling or complications.
  • This will optimise mobility of the joint affected and reduce any pain and/or discomfort that may appear after the surgery.
  • Improves trophism – nourishes the tissues around the operation site and encourages correct healing and closure of the surgical wound.
  • Restores motor skills, giving patients help, guidance and re-educating them adopt walking patterns that will soon have them on the road to recovery.

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