The Tendon transplant to work in a cross-band OP

In many cases, a SURGERY after a cruciate ligament tear is useful. Often, the cruciate ligament is replaced by the graft by a Tendon. As the OP runs out and what to keep in mind after the Operation.

An adverse movement, a sound like a whip, and a sudden pain, a ligament tear, sometimes faster than many suspect. The two cruciate ligaments are actually very robust, because they play for the stability of the knee joint has an important role: Together with the Outer and inner band forming the ligamentous apparatus of the knee joint, the knee with each movement and strengthens.

Seen from the side, the two bands intersect โ€“ therefore, you will have your name. A cross band runs from the Shin bone down the front to the thigh bone obliquely upward and backward (anterior cruciate ligament), the other one from the Shin from the bottom rear of the thigh obliquely to the front upper (posterior cruciate ligament). You have to prevent the femur sliding too far backwards and the Shin bone too far forward. Is one of the bands ripped (cruciate ligament rupture), can only produce an Operation with the necessary stability in the knee joint.

After an injury, and is suspected to have a ligament tear you should definitely go to the doctor. This can clarify with the patient what therapy is for a cure is necessary. Conservative methods, such as a targeted muscle building through physiotherapy, in each case, necessary in order to strengthen the knee after the injury. However, a pure muscle โ€“ building can replace alone, never a broken cross-band that shows the statistics: over 90 percent of the patient’s instability in the knee joint after sole treatment with conservative methods still.

About the author

Norbert Wynands is a specialist in surgery, accident surgery and sports medicine. He is senior physician of the Department of trauma and reconstructive surgery at the red cross hospital in Lindenberg.

Although the healing from the physical condition of the Person and your personal claim to your physical activity, the person Concerned, however: The younger and the more active, the more recommend is a surgery in which the ligament is replaced. With the following operational method of a cruciate ligament rupture can be treated.

Cross-band SURGERY with tendon graft

A virtually universal method of operation of the cruciate ligament by a tendon graft, the tendon of the thigh muscle (semitendinosus tendon, or quadriceps) or the patellar tendon of the patient is taken. The latter is the connection between the lower leg and kneecap. This minimally invasive, arthroscopic surgery (single-bundle reconstruction) is now one of the Standard methods of treatment and can be done up to one year after the injury.

When the Operation is first removed through a small incision in the replacement tendon. This is about a twenty to thirty centimeters long tendon is then placed four on top of each other, so that you are reduced to a quarter of the length and their tensile strength is significantly increased. Then be drilled in both the femur and in the tibia bone a small, approximately two-centimeter-long channels. By this, the two Ends are pulled tendon Replacement, tensioned and then fixed. The aim is that the replacement tendon in the subsequent conservation phase, with the bone fully fuses, so that the function of the cruciate ligament is largely restored.

Fasten the cross band set with a tear-resistant thread

The Fixation of the cruciate ligament set can be done using various techniques. One of these is the “Tight Rope”method is: The replacement tendon is pulled with a particularly tear-resistant medical thread (Tight Rope) by hauling technique in the drilled bone channels โ€“ first through the channel in the leg rail, then into the channel in the femur. This type of pulley allows the replacement tendon to take up slack in the best possible way.

In order to fix the string on the thigh bone, rolling papers, a small Metal about the filament introduced. As soon as the tendon was pulled through the top of the bone canal, the leaves on the outer side of the femur. Now it has a larger surface than the Radius of the drilled bone channel and thereby prevents a sliding Back of the cross-band set. Subsequently, the tendon is tensioned, and on the outer side of the opposite Shin bone is fixed with a screw.

With the time, the thread and the replacement tendon around the fabric, the Replacement ligament is based. In the subsequent conservation phase, the Tendon axes with the bone. The screw loosens over time, the metal flakes and the thread will remain in the knee of the patient.

Physical therapy is a Must

After a cruciate ligament tear should be waiting with the Operation until the knee of the patients want to completely off, and also is pain-free. Only then is it possible that the cruciate ligament replace the normal proportions of the Body. Often, concomitant injuries associated with cruciate ligament tears such as a meniscus tear. These are also only in a worn woolen knee completely visible and need to be treated in order to obtain an intact joint.

Even if surgery, everything runs optimally, can be replaced the function of the natural cruciate ligament, never to 100 percent. However, it can be manufactured by means of a minimally invasive procedure and the relevant volume set, the stability of the knee joint.

Without an accompanying physiotherapy and without the will of the patient, regain mobility and strength in the leg, but. Those who make the effort and diligently by the skilled person recommended, and injury to and healing degree of coordinated Exercises, therefore, has the prospect to be able to his knee after six to eight months to fully re-charge. An external knee brace (orthosis) is the patient in everyday life also safety, and prevents Twisting of the knee.

With 2 simple knee Exercises, you prevent joint pain

Our knees need to withstand quite a lot: every Day, we bow down to you, on average, more than 1000 Times. Each time you walk the multiple rests of our body weight on them. The largest and most complex joints in spite of continuous load fit, we should be active.

Millions of people complain of inflamed, swollen or aching knees. No wonder: No other joint is daily burdened and stressed like this. Not just Sprinting, or skiing, it must keep the face of tremendous pressure: At each knee flexion the largest and most complex of our joints wearing the Seven – to-eight times our weight.

So it crunches in the short or long-each time you Bend or stretch, pinches or hurts, movement is important. A good Alternative to the gym or sports field offer aerobics or Zumba: The combination of dance and Fitness brings the body into swing, can the pounds and promotes flexibility and strength.

The benefit not least to the knees: Regular exercise also improves the metabolism and blood circulation of the knee joint. In addition, a strengthened muscles protects the knee joint injuries and diseases.

In order to prevent Overuse of the musculoskeletal system, we recommend a moderate, age-appropriate and not too intense workout. In the case of existing complaints of the feet or knee joints, you should avoid, however, be on sports completely, or with an orthopedic surgeon, a gentle approach discuss.

Two Exercises for healthy knees

1. Flat on your back and raise one leg. The foot towards the buttocks. After a few seconds stretch out. The Whole thing a dozen Times with each foot repeat.

2. Sit on the table and the legs swing freely. As a result, the joint is spread grease over the entire cartilage surface of the knee joint. Cartilage nutrition is significantly improved.

The best sports for healthy knees

Whether Zumba, Running, or Jogging – regular exercise, without excessive ambition, the best medicine is “”. Muscles, Tendons and ligaments to be strengthened in a healthy way – a slow warm – up and training. As particularly knee-friendly apply

  • Swimming
  • Hiking
  • Gymnastics or water aerobics

    To the PDF guide

Simple measures in everyday life

Of the (knee)health and conducive to regular Cycling to work or for shopping. Improper loading, such as when Running can occur are virtually eliminated. All of the muscles that stabilize the knee, to be trained.

But smaller steps can achieve quite a lot. One of the simplest Precautionary measures: often times take the stairs instead of the lift. Each stage strengthens the muscles, invigorates the knee metabolism and thus prevents osteoporosis.

Long hours of Sitting in the car, office or TV chair increases the need to be active: Remains of a joint in a rigid Position, so that the cartilage layer is loaded permanently on a body and to lose excessive joint fluid. This happens more often in the day, so the risk of cartilage damage is increasing rapidly, as when a clothing is claimed always in the same place and a hole forms.

  • You can change as often as possible the work or the position of the seat.
  • Get up once in a while.
  • You are going short distances.
  • Stretch at your Desk more often the knee.

The less strain on the joints

In addition to a lack of exercise is a prolonged Standing “poison” for the knee. Because then the full body weight rests on the connection point between the upper and lower leg bones. Better time to take a breather in the Sitting load, and several times a day, the legs dangle. This promotes the formation of synovial fluid.

Should avoid, to the extent possible, longer Work in stop position (for example, when Mounting or crafts), as well as a strong knee flexion, so the cross-legged or with frequent Squatting. Problematic is also the following sports are:

  • Football
  • Handball
  • Squash
  • Tennis
  • Rowing
  • Skiing

In the case of rotational movements of the knee under load, typically for the Kick, or skiing, are the the cartilage protective menisci are especially prone to injury.

Instead of high shoes that make it difficult to straighten the joints, better flat shoes with soft sole wear. They dampen vibration while walking and protect the joints. The Same is true for an “acceptable” body weight. Because obesity is one of the main risk factors for osteoarthritis or other knee ailments.

About the expert

Sven Ostermeier Orthopaedics and accident surgery, sports medicine, chirotherapy and special orthopedic surgery. The shoulder and knee expert, works as a senior orthopaedic surgeon of the joint-clinic Gundelfingen. He is also the instructor of the German Association for arthroscopy.