Structures that make up the knee
The knee is one of the most complex joints in the human body, designed to bear loads and allow essential movements such as walking, running or jumping. Understanding its structure is key to understanding injuries such as anterior cruciate ligament rupture.
This joint is made up of a series of elements that work together to ensure its stability and functionality:
- Central pivot: formed by the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). It is responsible for stabilizing the knee against translational and rotational movements.
- Internal compartment: It is made up of the internal lateral ligament (LLI), which provides medial stability.
- External compartment: formed by the external lateral ligament (LL) and the tendons of the popliteus muscle, it contributes to lateral stability.
- Menisci: Located between the femur and tibia, the medial and lateral menisci are crescent-shaped cartilage structures that perform crucial functions such as absorbing shock, distributing joint weight and reducing cartilage wear.
He anterior cruciate ligament (ACL) It is composed of fascicles or bands that act as powerful stabilizers of the knee. This ligament prevents anterior translation of the tibia, and external and internal rotation and angulation of the knee. In addition, it is a connector that joins the femur and tibia bones, being essential for the biomechanics of this joint.
What is a cruciate ligament tear and how does it occur?
Ligament rupture is when totally or partially break the fibers that make up the knee jointThere are different degrees of severity depending on the level of the rupture (strain, partial tear or complete tear). This injury can significantly affect the stability of the knee, limiting mobility and causing pain.
Causes and evolution of the anterior cruciate ligament rupture of the knee
ACL tears are usually the result of a knee sprain while the foot remains supported on the ground. This injury is common in sports activities such as football, handball, basketball or skiing, in which sudden turns of this part of the body occur.
When the anterior cruciate ligament is torn, the patient usually presents with an acute clinical picture of pain and limping. The joint also becomes inflamed and if this is very intense, it sometimes needs to be evacuated by removing it with a syringe (arthrocentesis). In this advanced phase, exploration of the knee is difficult due to pain.
Main symptoms of ligament rupture
ACL tear is characterized by a set of symptoms that allow the severity of the injury to be quickly identified:
- Click: Many people describe feeling or even hearing a “crack” at the time of the injury.
- Intense pain: The pain appears immediately and persists in the following days, considerably limiting mobility.
- Joint instability: The knee may give the sensation of giving way when trying to put weight on it.
- Bruising and stiffness: In some cases, a bruise may appear around the knee along with a significant limitation in range of motion.
Diagnosis of anterior cruciate ligament rupture
If you suspect an anterior cruciate ligament rupture, it is important to go to a knee specialist traumatologist as soon as possible. First of all, an X-ray of the knee should be performed to rule out fractures and an MRI with which to confirm the break and study the possibility of other injuries such as torn meniscus, injuries to the cartilage or edema in the tibia or femur due to the collision of one bone with another.
An early and accurate diagnosis is essential to determine the best therapeutic approach, whether conservative or surgical, and ensure optimal recovery.
How is a torn anterior cruciate ligament healed?
Surgery is the only treatment that will allow for complete rehabilitation and the ability to return to sports. Until the time of surgery, there are some methods to alleviate pain, such as rest, the use of ice to reduce inflammation, and bandages applied by a specialist doctor. It will also be necessary to use crutches before surgery to avoid putting weight on the knee and further injuring it. These measures not only provide relief to the patient, but also optimize the condition of the knee for surgery and subsequent rehabilitation.
Treatment of anterior cruciate ligament injury
The method used consists of the ligament reconstruction by using a graft that performs the functions of the original ligament. There are two main options for obtaining this graft:
- Use the patient's own ligaments, mainly the patellar tendon or hamstring tendons.
- Use of ligaments from a tissue bank donor.
He trauma team by Prof. Dr. Elgeadi avoids the morbidity of extracting the patient's own graft, using the allograft (donor) technique, either with tendons, or with bone and patellar tendon (HTH allograft technique).
What is anterior cruciate ligament surgery like?
Surgery to repair the anterior cruciate ligament consists of fixation of the plasties in the femur and tibia. To achieve this fixation, different devices can be used: screws, pins or suspension systems mainly.
A fundamental part of the intervention is the anatomical placement of the plasty, that is, placing it in the same place as it was before it was torn. To ensure precision in this process, a specialized guide system must be used that allows the insertion tunnels of the plastic in the femur and tibia to be made with the greatest possible precision. This precision is crucial to ensure the functionality of the new ligament and to optimize the post-surgical results.
The anterior cruciate ligament surgery It usually lasts approximately 50 minutes and is performed with anesthesia in the lower limb (intradural anesthesia). After the intervention, the patient usually stays one night in the hospital for analgesic control and to allow the extraction of intra-articular bleeding by means of placement of a round, which is removed the next day.
How long does anterior cruciate ligament recovery take?
Recovery from cruciate ligament surgery is a gradual process that usually extends between four and six monthsThe speed and effectiveness of recovery largely depends on the patient's discipline in following medical instructions.
Specialists often divide the rehabilitation into two major stages: before and after the first month. Below we detail the recovery phases after anterior cruciate ligament surgery:
- Week 1: During this initial stage, it is essential that the patient rest completely, keeping the leg elevated and applying ice to promote circulation and the necessary rest.
- Week 2: generally in this week the specialist traumatologist The stitches will be removed and the patient will have to, in addition to continuing with the ice applications, begin to move and do knee bends to give mobility and maintain muscle tone. The patient will begin to walk, but will always need to do so using crutches so as not to overload the joint.
- Week 3: the guidelines from the previous week will be maintained, but some more will be incorporated mobility exercise to strengthen the knee, now trying to force my knee a little to return to reality. It is highly recommended to swim from this stage of rehabilitation onwards.
- Week 4: accompanied by a physiotherapist specialized in sports rehabilitation, the patient will begin with balance and stronger muscle exercises.
In order to achieve a full recovery, it is important that, after the first month, the patient continues with physiotherapy sessions to complete the rehabilitation properly. It is important to avoid becoming overconfident at this stage, since beginning treatment prematurely can compromise the success of the recovery.
Physical rehabilitation is essential to achieve a tight and resistant ligament, with adequate muscle strengthening. The process begins with mobility exercises and ends with muscle strengthening. During the first six months, intense sports should be avoided, although the patient will be able to walk without crutches after the third week.
If you need more Information about Anterior Cruciate Ligament Injury do not hesitate to contact our traumatology medical team To be able to help you.
Innovation in anterior cruciate ligament reconstruction
Until now, the methodology used for this type of surgery consisted of replacing the fractured or torn anterior cruciate ligament (ACL) with a tissue graft from the patient himself or another obtained from a donor.
This new procedure preserves and maintains the cruciate ligament itself through a suture. This technique has only been used in some hospitals in Switzerland and Germany, although it is gradually being implemented in Spain. However, this innovative surgical technique, developed by a team of professional Swiss surgeons, specialized in sports injuries, is ideal for all those patients who regularly practice sports or whose daily activity requires a high degree of stability and proprioception (deep sensation obtained by the receptors of the osteoarticular and muscular system).
Advantages of the new anterior cruciate ligament reconstruction
The recovery of the anterior cruciate ligament offers important and tangible advantages over previously known techniques. The immediate mechanical stabilization of the knee It is one of the benefits most highlighted by health professionals specialized in the sector, since it allows earlier rehabilitation. Self-healing of the break is also promoted and deep sensitivity is restored. Furthermore, for this technique it is not necessary to take tendons or grafts from the patient himself, so the surgery time is considerably reduced and, in this way, pain control in the postoperative period is more precise and accurate.
Patients who undergo this innovative surgical technique particularly value these advantages. In addition, the lower socioeconomic cost is a notable aspect, since work disability after surgery lasts less on average than with traditional reconstructions, which favours a quicker return to work.
Recovery of the anterior cruciate ligament (ACL) after the double tunnel technique
This treatment is based on the healing potential of the cruciate ligament itself, together with the placement of an implant that provides optimal conditions of stability for the biological healing of the rupture of said ligament.
To provide easier self-healing of the fractured component in each patient, the ends of the cruciate ligament injury are approximated through sutures. Besides, the regeneration of the ligament itself is generated through a microfacture procedure, which allow stem cells from the nearest bone to approach in order to accelerate the healing process of the cruciate ligament.
In the healing process, not only the ligament tissue is regenerated, but also the sensory nerve fibers altered by the trauma., thus restoring the innervation of the ligament. This aspect offers patients the opportunity to regain full sensitivity to the anterior cruciate ligament and, therefore, that of the knee. This innovation in the healing method is a treatment that has not been offered until now.
Factors that we must know to implement the new cruciate ligament recovery
The only factor that must be taken into account in order to apply the mentioned technique is that the damaged anterior cruciate ligament retains “sufficient vitality and capacity” to be able to recover. This circumstance can occur during the first weeks immediately after the ligament injury, so it is recommended that the surgical technique be applied within the first three weeks after the injury. It is true that, with time, it is expected to achieve ligament repair in injuries lasting more than a month.
We cannot forget that an injury can have a different scope depending on the intensity of the trauma. The ACL injury can be accompanied by meniscal injuries, osteocartilaginous injuries, injuries to other ligaments, etc. Furthermore, it has been shown that when faced with the same injury, there are people who react with biochemically disproportionate inflammation, so we must be careful and go to a trusted professional.
Traumatology clinic for anterior cruciate ligament surgery in Madrid
In cases of injuries such as anterior cruciate ligament rupture, it is crucial to go to a specialized center with traumatology experts capable of offering the most appropriate treatment for optimal recovery. Prof. Dr. Elgeadi's team has extensive experience in treating these types of injuries, guaranteeing patients the best possible recovery.
For more information or to schedule an appointment, please do not hesitate to contact our team.
52 thoughts on “La rotura de Ligamento Cruzado Anterior: innovación en la reconstrucción.”
Hello, a month ago I had anterior cruciate ligament reconstruction surgery and chondrosplasty, but lately my knee often locks up when I go to think about it. It is normal?
Hello Maria!
The most appropriate thing is that you consult the professional who carried out your intervention. If you have any questions, do not hesitate to write to us at our email [email protected] where we will be happy to assist you.
All the best!
Hello, my name is Kenya, 6 weeks ago I had ACL reconstruction surgery and my knee continues to be swollen and painful, is this normal?
Hello Kenya!
Due to the symptoms you present, it would be best for you to go to your trusted traumatologist so that he or she can perform a complete evaluation of your injury. If you have any questions, do not hesitate to write to us at our email [email protected]
All the best!
Good afternoon, I had ACL surgery 4 years ago and in an accident the surgery was damaged and they are going to operate on me again. Will it be possible for me to let myself have the surgery or should I stay as such? What do you recommend?
Hello Yeison!
The most appropriate thing is that you follow the instructions of your trusted traumatologist, since he is the one who has enough information to decide whether it is more appropriate for you to undergo an intervention or not. However, if you have any questions, write to us at our email [email protected]
All the best!
Hello, 2 months ago I had surgery on my ACL, external meniscus and patella, but the scars burn, is this normal?
Hello, Liliana!
It is best that you go to the specialist who carried out your intervention so that he can evaluate your symptoms. Do not hesitate to write to us at our email [email protected] where we will be happy to answer your questions.
All the best!
Hello, I had surgery a week ago and when I want to bend my knee a little I feel a pull on my femur, and I'm afraid it will break. Is that sensation normal? Can it break?
Thank you.
Hello, Eugenia!
The symptoms you mention are very common, therefore, after the recommended time of rest, it is important that you undergo a scheduled physiotherapy treatment that allows you to regain mobility and strengthen the muscles in the area. However, we will be happy to answer your questions in our email. [email protected]
All the best!
2 days ago I had a semitendinosus graft in my ACL due to a total tear due to trauma in a fall. I have a brutal pain, I don't know how long it is reasonable to endure, when do I start to notice improvement?
Greetings
Hello, Amparo!
It is best for your doctor to prescribe an anti-inflammatory treatment to help relieve pain. However, in a few days you will begin to notice improvement. If the pain persists, you should go to your doctor. If you have any questions, we will be happy to assist you by email. [email protected]
All the best!
Hello. A month and a half ago I had an arthroscopy for an ACL graft.
The traumatologist used an anatomical transport technique, as he told me, and performed an "augmentation" of the ACL, since it was mostly torn, not completely torn.
My question is: does this decrease recovery time?
I am doing kinesiology on time and plan to return to recreational soccer in December 2021. Is this okay?
Hi Carlos!
In this case, it is best to follow the instructions of the professional who is treating you, since he or she is the one who knows the status of your injury. However, we recommend that you return to physical activity progressively, to avoid relapses of your injury. Write to our email [email protected] in case of any doubt.
All the best!
Hello, good afternoon, my son had surgery, ligament tecondyruction, yesterday he was vaccinated and he has a lot of pain, a lot in the operated knee, it is normal due to a reaction to the vaccine, there is no inflammation or redness, his points are without infection. They told you only paracetamol for the vaccine, can I give you something stronger?
Hello Monica!
It should be the doctor who prescribes the most appropriate treatment, once the symptoms have been studied. However, if you have any questions, write to us at our email [email protected]
All the best!
Hello, good afternoon,
In February playing handball I was injured with a partial tear of the anterior cruciate ligament.
The traumatologist who treated me told me that he would not operate on me, that it was not necessary, but I want to continue playing handball.
I would like to know how long I have to strengthen my knee to return to playing and what exercises are to strengthen it,
Thank you and greetings.
Hi Fatima!
The most appropriate thing is that you go to a physiotherapist. Since they will be the ones who can help you strengthen your muscles through personalized exercises. Do not hesitate to write to us at our email [email protected] in case of any doubt.
All the best!
Hello, next August 30th will be two months of surgery on my ACL with a semitendinosus graft.
I don't have full knee extension, is this normal? I have flexion at approximately 130 degrees…Is extension gradually recovering? Or would it be normal for me to have it at 100©?
Hello Jesus!
The mobility of the joint is progressively recovered. Therefore, rehabilitation takes on special importance. If you have any questions, write to us at our email [email protected]
All the best!
Hello, my son is 22 years old. He plays competitive soccer. 4 years ago he tore his cruciate ligaments, he had surgery on the same tendon. Today, after 4 years, he has torn his ligaments again, in the same knee and same injury, anterior cruciate ligament. .. My question, do you have to have surgery again?
There is some possibility of being cured with therapy or some means. He will be able to play competitive soccer again.
Good morning, Alberto.
For such a specific pathology, it is not possible to provide you with a precise diagnosis without having performed a prior medical examination. You can make an appointment with our specialist traumatologists and we will take care of finding the best solutions for your child.
Greetings.
Hello. My daughter tore her ACL in a soccer game. She plays several sports: soccer, karate and handball.
How do doctors suggest operating?
There are those who say that he is very young but sports are his life. Specifically football, if I had to give it up I would suffer great depression. If they do not operate it to be able to continue with the activity without causing other damage, what do you advise?
Good morning, Alice.
We are very sorry for your daughter's pathology. We cannot offer you an answer without first performing a complete medical diagnosis. Our advice is that you go to our Madrid trauma clinic to offer the best treatment to your daughter.
Greetings.
Hi there. I have a 15-year-old son who, during a dispute in training, suffered a medial collateral injury and a tear in the lateral band of the cruciate. There was no swelling or hematoma except in the collateral area. What option would you choose for treatment, conservative or surgical, thank you
Good morning, Jorge.
We cannot offer you an answer without first performing a complete medical study. Once the results are obtained, we will offer you the best treatments for your pathology.
Make an appointment at our Madrid trauma clinic and we will treat your trauma injury effectively and professionally.
Greetings.
In a diagnosis of ACL with partial fiber rupture of up to 10%, is surgery necessary or what is the treatment?
Good morning, Jennifer.
Thank you very much for reading and commenting on our blog. To offer you the best possible treatment for your pathology, it would be necessary for you to go to our trauma clinic to carry out a complete medical study. You can make an appointment with our specialist traumatologists through our website.
All the best.
Good morning, 4 months ago I had an arthroscopy for ACL and meniscus suture and I have not yet regained strength in the muscle, I cannot raise my knee and hold it, and my knee is still swollen and when I walk I feel unstable. The doctor gave me reinstatement from work. and that I can wear heels, I would like to ask for an opinion. I don't know if it is better to have an MRI to really know how my knee is.
Good morning, Liliana.
Thanks for reading our blog. There are many factors that can influence recovery after undergoing surgery. For your particular case, it is recommended that you go to our team of specialist traumatologists to be able to offer you a complete medical diagnosis.
All the best.
Good afternoon, my 14-year-old daughter has undergone ACL surgery, with THT allograft, she has 100% flexion and bending, in fact, she has never had limitations in mobility, only some discomfort from time to time. She has been undergoing surgery for 6 months and doing daily rehabilitation, since the day of the injury. How much longer should you wait to resume your sport (football)? Thank you.
Good morning, Manuel.
Recovery time depends on many factors, including the surgical technique used and the severity of the injury. Therefore, an approximate date cannot be given without evaluating the patient first.
Without a doubt, following physiotherapy and rehabilitation treatment will help make the recovery time shorter. You can make an appointment with our specialist traumatologists to offer you a complete medical diagnosis.
All the best.
Hello, I have a problem. I had surgery on my ACL and external meniscus. I have been resting at home for a week, but the other day I accidentally put my foot down and I put pressure on it while sitting. The next day I noticed punctures or cuts behind the leg. knee, when I flex it it hurts below and above the kneecap. Could I have broken something?
Good morning, Miguel.
Thank you very much for your comment on our blog. For cases as specific as the one you present, we advise you to request appointment with our knee specialist traumatologists. In this way, they will be able to diagnose the area and determine the most appropriate treatment for the pathology.
All the best.
Good morning,
Currently I have partially torn my ACL, there are those who recommend that I not have surgery, and those who (due to the great physical activity that I do) recommend that I do it or it will end up breaking soon. What is more recommended? How much recovery is approximately after a partial rupture operation?
Thank you so much
Good morning, Jorge.
To offer you the most appropriate treatment, it is necessary to undergo a complete medical study. To do this, you can contact our knee traumatologists. Likewise, recovery time will depend on numerous factors such as the severity of the injury or the surgical technique used.
All the best.
Good afternoon; At the end of 2017 I had surgery for an ACL tear, when I was 55 years old. The operation was very good, but until today I have not been able to recover well. I have pain, I can't bend my knee to bend over, or run. I go to the gym, but I am very limited with the exercises, because if I do lunges, the next day my knee bothers me a lot. The doctor tells me that my knee is fine, but that I lack muscle. I give everything to improve, but it costs me a lot. Would it be advisable to use a special knee brace to be able to do more exercises? Thank you very much in advance. Greetings.
Good morning, Sandra.
Thank you very much for commenting on our blog. For issues like the one we are discussing, a prior diagnostic study would be recommended, in order to determine the most appropriate treatment. To do this, you can contact the Elgeadi Traumatology team at the following link: https://elgeaditraumatologia.com/contacto/
All the best.
Hello, in two days it will be a month since I had an ACL operation using the patella as tissue, I don't know what the estimated time is to be able to drive if I don't feel pain when doing it, but do I have any advice, if it doesn't hurt, could I continue driving?
Good morning, Brian.
Thank you very much for reading our article. The most advisable thing would be to consult with a specialist traumatologist, so that they can evaluate your case through a complete diagnosis of your pathology and determine the appropriate treatment. You can make an appointment with our team of knee traumatologists at the following link: https://elgeaditraumatologia.com/cita-privada/
All the best.
Good evening, 5 months ago I had an arthroscopy to reconstruct the ACL, I persisted with a lot of pain and limited mobility when walking, especially. Now I find that I have a torn meniscus. Are there treatment alternatives without having to resort to surgery again? What do you recommend in these cases? Conservative treatment or surgery?
Good morning, Micaela.
Thank you for your comment on the blog. We are sorry for the situation you are in. We recommend that you consult with an expert traumatologist so that he or she can evaluate your pathology and determine the necessary treatment. You can make a private appointment with our expert knee traumatologists in the link provided.
All the best.
Good night.
I wanted to know if they still use this technique (Recovery of the anterior cruciate ligament (ACL) after the double tunnel technique) and if they have more information about it.
I had a knee injury and I want to find out about different techniques.
Thank you
Greetings
Hello Agustin,
I would like to review all the images and tests you have if they are positive for a suprascapularis injury. We can try to do an endoscopic release.
Thank you!
3 days ago I had an astroscopy for having a torn anterior cruciate ligament, and I have rested and the inflammation and pain has gone down a little. They grafted a new ligament to my leg. Can I start forcing my knee to bend or is it too soon? ? Be careful, it hurts where they removed the new ligament, not the knee
Hello Edith,
It is best for your doctor to tell you, as your recovery progresses, if you can start rehabilitation and exercises.
Without seeing it in person it is difficult to give another recommendation.
Greetings
Good morning, a month ago I had a cruciate and posterior reconstruction, I would like to know if during my recovery I can practice skating to strengthen my legs, thank you very much.
Hello John,
For rehabilitation we always recommend performing strengthening exercises under the instructions of a physiotherapist. And start sports activities once the physiotherapist indicates it.
Greetings
Hello, I have cruciate ligaments and fluid in my knee. They told me that they are going to do surgery in 3 months and while I can continue working, nothing was happening. Is that normal or do I look for other opinions
Hello Katherine,
Yes, it depends on each case and the job you have (if you work from a sitting desk or have to do demanding physical activity).
In principle nothing would happen.
Greetings
Hello, good afternoon. I'm Oziel. I just had ACL knee surgery. I'm 12 days old. Do you recommend walking and how many minutes a day or how many times a day? Also, I can't flex my knee properly. Is this normal?
Hello Oziel,
Thank you for sharing your experience. After ACL surgery, it's normal to initially have limited knee flexing, and the recovery process is gradual. The type and amount of walking or exercise should be prescribed by a specialist, depending on how your condition progresses.
Greetings.