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Treatment

Treatment methods

There are various options for the treatment of a cruciate ligament rupture. The decision depends on various factors, such as the age and activity level of the person concerned. Options comprise treatment without surgery; surgery with preservation of the cruciate ligament; and surgery with reconstruction of the cruciate ligament. Each method has its advantages and limitations.


Preservation of the cruciate ligament with the Ligamys implant

With the Ligamys method, the patient’s own cruciate ligament is preserved. The knee is stabilised by means of an implant, so that the cruciate ligament can heal up again. The procedure is performed within 21 days after the cruciate ligament rupture.

Work can be resumed after an average of three weeks. About six months after surgery, light, non-strenuous sport should be possible again. Contact sport with changes of direction can be practiced again after nine months at the earliest.

  • Preservation of proprioception (depth sensitivity)
  • No surgical procedure for withdrawal of a donor tendon is necessary
  • No risk of complaints at the donor site

Pros

Advantages

  • Small time window: within 21 days after the rupture
  • Not suitable for all cruciate ligament ruptures. This is to be ascertained at the beginning of the surgery. If the Ligamys implant cannot be used, a conventional cruciate ligament reconstruction is performed
  • General risks of surgery

Cons

Limitations

Reconstruction with tendon transplant

In a reconstruction, the torn cruciate ligament is surgically removed and usually replaced by a tendon from the patient’s body. This method is suitable for patients who have a high level of activity and who do not achieve sufficient knee stability with conservative therapy.

The procedure can be performed as soon as the swelling has subsided. During surgery, the torn ligament is usually completely removed. The replacement ligament is anchored in the femur and tibia.

The rehabilitation phase is similar to the procedure with the Ligamys implant. Work can be resumed after about three weeks. After six months light sport should be possible again, while contact sport with changes of direction is possible again after nine months at the earliest.

  • Tried and tested, well-documented procedure
  • Large time window for the procedure
  • Alternative to other treatments, if the desired success fails to materialise

Pros

Advantages

  • Proprioception in the ligament cannot be restored
  • The knee may be further weakened by the removal of a tendon from the patient’s body
  • Possibly complaints at the donor site
  • General risks of surgery

Cons

Limitations

Conservative treatment without surgical intervention

Conservative therapy does not involve surgery. Knee stability is promoted with consistent physiotherapy and strength training.

This method is primarily suitable for patients who, despite rupture of the cruciate ligament, have a feeling of sufficient stability in the knee. The rehabilitation phase varies in length – the attending physiotherapists specify an individual time frame.

  • No surgery
  • No complications due to anaesthesia
  • No risk of infection from a surgical intervention

Pros

Advantages

  • The instability is not addressed causally
  • The ligament often does not heal, or the stumps may grow together in the wrong place
  • The instability may lead to secondary damage
  • Continuous muscle build-up necessary

Cons

Limitations

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