Arthroscopic Reconstruction of the Knee for Ligament Injuries
The knee is the most complex joint in the body and is formed by the articulation between the thighbone (femur) and the shinbone (tibia). A kneecap is present over the front of the joint to provide extra protection. These bones are held together by four strong rope like structures called ligaments. Two collateral ligaments are present on either side of the knee and control the sideway movements of the knee. The other two ligaments are the anterior and posterior cruciate ligaments, ACL and PCL respectively, which are present in the centre of the knee joint and cross each other to form an “X”. The cruciate ligaments control the back and forth movement of the knee.
Knee Ligament Injuries
Knee ligament injuries are common in athletes involved in contact sports such as soccer, football and basketball. Knee ligament injuries are graded based on the severity of injury.
- In grade I the ligament is mildly damaged and slightly stretched, but the knee joint is stable.
- In grade II there is a partial tear of the ligament.
- In grade III there is a complete tear of the ligament and the ligament is divided into two halves making the knee joint unstable.
Arthroscopic Knee Ligament Reconstruction Procedure
The surgical repair of the completely torn ligament involves reconstruction of the torn ligament using a tissue graft taken from another part of the body or from a donor. The damaged ligament is replaced by the graft and fixed to the femur and tibia using strong non-dissolving sutures and titanium buttons. Gradually, over a period of a few months, the graft heals into the bone tunnels. The knee is then rehabilitated in a dedicated manner with a physiotherapist. Provided the knee swelling and discomfort resolves, then return to running in straight lines by 4 months, cutting or pivoting movements from 6 months, non-contact training from 9 months, and return to sports from 12 months.
Arthroscopic reconstruction of the knee ligament is a minimally invasive surgery performed through a few tiny 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 the surgeon on a television monitor. Guided by these images the surgeon performs the surgery using small surgical instruments inserted through the other small incisions around the knee.
Advantages of Arthroscopic Knee Ligament Reconstruction
As the surgery is performed through small incisions it provides the following benefits:
- Less postoperative pain
- Shorter hospital stay
- Quicker recovery.
Following arthroscopic reconstruction of the injured ligament most athletes can return to their high-level sport after a period of rehabilitation.