Anterior Cruciate Ligament Surgery
Situations that Require Cross Ligament Surgery
Cross ligament surgery falls into the reconstructive surgery category when the tissue group that connects the thigh bone to the shinbone at the knee joint, also known as the anterior cruciate ligament, is damaged due to various reasons.
The anterior cruciate ligaments around the knee are damaged during sports such as skiing, tennis, squash, football, and basketball. In fact, these types of knee injuries constitute about 40% of all sports injuries. However, sudden movements (sudden change of direction, falling, sudden stopping, twisting of the knee, etc.) during daily activities can also cause severe bending of the knee and lower leg, leading to the tearing of the ligaments.
If one of these causes tears the anterior cruciate ligaments, the person loses their balance and mobility because the knee cannot bear the body's weight. Surgical methods may need to be used to prevent the damaged ligaments from becoming irreparable.
Suitable Candidates for Cross Ligament Surgery
Individuals who will have cross ligament surgery must initially meet the following conditions:
Being suitable for the operation from a general health perspective (chronic diseases, age, etc.),
Not developing an allergic reaction to anesthesia,
Not responding to non-surgical methods such as physical therapy and rehabilitation,
Not being able to perform daily activities due to severe knee pain.
Moreover, the decision whether the person is suitable for surgery or not is made by the doctor by evaluating the results of various tests. At this point, the degree of damage and how much this damage affects the person's quality of life is also important. If there is no imbalance due to the knee problem, surgical methods may not be considered; the same applies to individuals who do not have an active lifestyle.
Preoperative Process
If surgery has been decided due to any damage to the cross ligaments, the doctor may want to wait for the swelling in the knee to go down before performing the operation. Additionally, the doctor may make the same recommendation for the development of the muscles in front of the thigh (quadriceps) and behind the thigh (hamstrings).
The waiting period lasts for about 3 weeks, and the person can be referred to physiotherapy during this period. After this waiting period, the range of motion in the knee will increase, making the recovery after the surgery easier.
Here are what patients need to pay attention to before cross ligament surgery:
If the physiotherapist has recommended exercises to help stretch the leg, they should be done regularly.
Avoid heavy activities that will negatively affect the knees.
Stay away from activities that involve sudden turns, jumping, and hopping.
Be careful not to put weight on the knees.
In addition to these, the following should be done shortly after the surgery:
The doctor should be informed about chronic diseases and the drugs used.
To avoid harmful bacteria, take a shower and come to the hospital with clean clothes.
The stomach should be empty before the operation (Exact information on this subject is given by the doctor).
Cross Ligament Surgery
No matter what the cause may be, when the cross ligaments are torn, it is not possible to repair them by stitching. Instead, damaged tissue is repaired by grafting to the affected area, enabling the reconstruction of the ligaments.
During the cross ligament surgery, the remaining torn tissue is cleaned, and a tendon from another part of the leg, such as the patellar tendon, the hamstring tendon, or the quadriceps tendon, is transferred to the damaged area. If there is no suitable tissue that can be taken from the patient's own body (autograft), synthetic graft or donor tissue obtained from a living source can be used.
These procedures are commonly performed using a medical device called an arthroscope, which is a thin, flexible tube containing fiber optic cable bundles that serve both as a light and a camera. This instrument reaches the damaged area through minimal incisions made in the knee and enables the procedure to be performed with minimal tissue damage.
After the graft tissue is placed and fixed with various medical screws, the doctor tests whether the operation is strong enough to keep the knee together. At this point, it is important that the knee is firmly fixed with full range of motion. When everything is deemed okay, the incisions are sutured, dressing is applied, and the procedure is completed.
Postoperative Process
The doctor will provide clear information about whether to stay in the hospital after the surgery; after a relatively simple procedure, it may be possible to return home the same day.
If the stitches used during the cross ligament surgery are absorbable, they will dissolve within 3 weeks, so they do not need to be removed; if not, they are removed by a healthcare professional after a few days. After that, if recommended by the doctor, the operated area is cleaned with warm water and antibacterial soap at regular intervals to prevent infection. Of course, it is important to move slowly and gently during the cleaning process.
During this process, bandaging of the knee may be necessary, and a special medical brace may also be recommended for wearing on the knee. This brace helps reduce swelling and provides support for the knee.
In the postoperative period, mild bleeding in the form of leakage, pain, bruising, swelling, and redness may be seen for approximately 1 week. If the doctor has prescribed painkillers, they should be used. If pain and bleeding increase, it is necessary to seek medical attention without delay.
In addition to all of these, since cross ligament surgery is a complex procedure, expecting full recovery to take place within a short period of time is not a correct approach. The knee may return to its pre-injury state within 6-10 months.
