Terms of rehabilitation after ACL rupture: inpatient and home recovery after surgery. Rehabilitation after plastic surgery

All materials on the site are prepared by specialists in the field of surgery, anatomy and related disciplines.
All recommendations are indicative and are not applicable without consulting the attending physician.

Knee ligament injuries are often referred to as sports injuries. This is quite understandable, since the strong elastic tissues that form the ligamentous apparatus that provides the articular functionality are damaged only under excessive loads or under hard contact impacts (shocks, falls). An experienced traumatologist can determine with great certainty the nature of an injury in a jumper, skier, tennis player, sprinter, basketball player, gymnast, based on accumulated experience and knowledge of the specifics of sports loads.

Causes of rupture of ligaments

With atypical loads, a partial injury (torn ligaments) or a complete violation of the integrity of the articular-ligamentous complex (rupture of ligaments) can occur. Impressed by the successes of athletes who develop tremendous speed on the ski slopes, setting records in high and long jumps, we cannot even imagine what overloads the musculoskeletal system can withstand, how synchronously and clearly muscles, tendons, ligaments work.

Only in one knee joint, in order to ensure flexion-extension, mobility, rotation and fixation in one position, four groups of ligaments take part:

  • Front cruciform;
  • Internal side;
  • Rear cruciform;
  • Medial collateral.

Each of the ligaments is vulnerable to certain types of external influences, after which conservative or surgical treatment is required. According to the statistics of official medicine, the most common is the operation on the anterior cruciate ligament, which is subject to serious trauma. Anterior ligament tears and ruptures are 20 times more common than posterior ligament complex injuries, with women being injured, on average, 6 times more often than men.

ACL (anterior cruciate ligament) injury

A tear or complete tear of the anterior cruciate ligament of the knee is associated with several types of atypical impact. The anterior ligament keeps the lower leg from excessive displacement forward and backward, allowing a certain excess of the physiological norm of the amplitude of movements due to the elasticity of the tissues forming it.

The causes of torn knee ligaments of the anterior group are:

  1. Sharp contact impact (hit on the lower leg or thigh);
  2. Subjective impact (sudden braking, landing after a jump);
  3. Displacement of the lower leg to the outside when the hip is rotated to the inner plane (injury of a basketball player during jumping with a turn);
  4. Displacement of the lower leg to the inside when turning the thigh outward;
  5. A phantom foot, or a skier's injury (ligament rupture during rotation of the lower leg and the joint at a right angle).

The gap in the ACL of skiers and slalomists is also associated with the specifics of sports equipment. During a backward fall, the upper edge of the boot transmits force to the region of the upper tibia. This type of load, in which the femur is displaced backwards, and the lower leg is held by the edge of the boot, causes a rupture of the anterior cruciate ligament.

Posterior cruciate ligament injury

Rupture of the posterior cruciate ligament of the knee joint is much less common. Basically, this department of the articular apparatus is damaged by direct mechanical impact, which happens during car accidents, direct blows to the knee (hockey injury), falling from a mountain, lifting a lot of weight (weightlifter injury).

With this injury, a severe pain syndrome occurs, which patients often compare with the action of an electric current. The knee quickly swells, the skin in the area of ​​the injury turns red. Forward movement, flexion or extension of the knee becomes impossible. Sometimes swelling extends far beyond the joint, descending to the lower leg and ankle.

Combined injuries

Ruptured cruciate ligament of the knee it is often combined when the meniscus, vascular complex, soft tissues are damaged. If an experienced traumatologist quickly determines the nature of ligament damage by severe symptoms and the circumstances of the injury, then the associated pathological processes are determined using radiographs, arthroscopy, CT and MRI. A severe case in medical practice is considered to be a multiple injury when a knee fracture, tendon sprain and ligament ruptures in several places occur.

Urgent knee ligament surgery

In surgical practice, there are several methods and philosophical approaches to knee ligament surgery. The specialist chooses the technique based on the nature of the damage, age, condition of the patient, clinical indications.

Urgent ligament repair surgery is performed within 2-5 days after the injury. The patient is taken to the hospital with complaints of severe pain in the knee area, loss of motor function.

First aid is carried out according to the standard scheme - removal of blood from the articular cavity, fixation of the limb with a compression bandage. After an operative diagnosis, the surgeon prescribes an operation to stitch the torn ligaments together (if the examination did not reveal a meniscus rupture, a knee fracture and other injuries that require special preparation for radical surgery).

Of great importance is the promptness of assistance, since torn ligaments quickly shorten, lose elasticity, and their ends dissolve. If the operation is not performed in the next few days after the injury, a more serious intervention will be required in the future - plastic surgery of the knee ligaments.

The operation is prescribed if the doctor considered it inappropriate to carry out conservative treatment. Modern diagnostics makes it possible to assess with a high degree of certainty the chances of successful treatment using radical and conservative methods.

Reconstruction of the knee ligaments

Reconstruction, or plastic surgery of the knee joint, is indicated for old injuries, when more than two months have passed since the damage to the articular apparatus. By this time, the ligaments are shortened, partially atrophied, and completely lose their ability to stretch.

To replace the lost fragment, a synthetic material or part of the tendon is used. Artificial substitutes are used in the treatment of elderly people, and for young patients, plastic surgery is performed using a graft taken from the tendon of the patellar ligament or tendon of the semitendinosus muscle. Own biological material is called an autograft, taken from a donor - an allograft.

Standard scheme for ligament plastic surgery

For anterior cruciate ligament surgery, an anterior-internal approach is used, for posterior (ligament) surgery, a posterior-internal approach is used. If you have to restore several ligaments at the same time, anterior-internal access is practiced. An additional incision is made in the area of ​​the knee joint, and in the area of ​​tissue extraction for the graft (along the outer surface of the thigh).

The patient lies on his back (anesthesia epidural or general anesthesia). Holes are drilled on the surfaces of the lower leg and thigh for the graft. A strip 3 cm wide and about 25 cm long is cut out of the fibrous femoral tissue (fascia). The tape is pulled into the created holes and crossed over the area of ​​ligament rupture, after which the graft and ligament are sutured with a strong biopolymer material (absorbable fixators).

Wounds are sutured in layers, drainage is established. The final stage is the immobilization of the limb with a plastic splint. There are other techniques for performing ligament plastics - the choice of method is carried out by the surgeon, based on the nature and extent of the injury.

Reconstruction using the patellar ligament is more complex, but provides an excellent result (in terms of knee stability and mobility). The essence of the operation is as follows: the surgeon cuts off part of the ligament along with bone fragments, which is necessary to fix the graft tissue in the joint bone. The fusion of the ligament with the cancellous bone is carried out within three weeks. Fixation of the autograft in the bone canals is carried out using titanium or biopolymer (absorbable) screws.

Ligament repair surgery using an arthroscope

Arthroscopy is a low-traumatic operation in which the surgeon performs manipulations under the control of a special apparatus without exposing the joint. Surgical access - 2 small punctures (no more than 2 cm), through one of which a miniature optical camera is inserted, through the other - instruments. Optics gives an increase of 40-60 times.

In complex combined operations, a partial resection of the meniscus and restoration of the cruciate ligament are performed simultaneously. The most difficult moment is to determine the degree of tension of the graft, which, together with the ligament, should ensure flexion, extension, tension of the muscles of the joint within the atomic norm. A weak tension will lead to loosening and instability of the joint, a tight fixation entails a restriction of the mobility of the knee.

Video: plastic surgery of the anterior cruciate ligament of the knee joint

Preparing for the operation

The preparation period for the operation is 2 weeks. During this time, doctors draw up a treatment regimen, choose a surgical technique, taking into account the age of the patient and his lifestyle (most athletes plan to return to their previous loads). The patient is told in detail how the operation will take place, what actions should be taken in the first and subsequent days of hospital stay in order for the recovery to be most effective. The patient takes tests, undergoes a diagnostic examination by specialists in the direction of the operating doctor.

Contraindications for knee ligament surgery

Contraindications are the same as for all other types of surgery:

Relative contraindications are the presence of degenerative changes in the articular tissue, atrophy of muscles and ligaments.

Complications after surgery

After ACL and posterior cruciate ligament surgery, complications are rare. Surgical treatment is carried out according to a well-established scheme, using high-tech equipment and instruments, which determines impressive rates of complete rehabilitation of patients, even with complicated injuries. However, the patient should be aware of the possible consequences. Side effects include the following manifestations:

  1. Pain syndrome within two days;
  2. swelling of the knee;
  3. Fever, temperature (reaction to surgery);
  4. Internal hemorrhages;
  5. Transplant rupture (very rare);
  6. Infectious inflammation of the bone tissue;
  7. Numbness of the limb (partial loss of sensation);

To prevent the development of sepsis and the formation of blood clots after surgery, antibiotics and anticoagulants are prescribed in prophylactic doses. By following the doctor's recommendations regarding preparation for surgery and behavior after surgery, the risk of complications is minimized.

Rehabilitation

The rehabilitation program after surgery on the ligaments of the knee joint is developed individually for each patient. Doctors schedule classes and procedures by the hour, requiring the exact implementation of all points. In the first days, rest and cold are shown on the operated area. On the third day, exercises are prescribed for flexion-extension of the joint with the help of an elastic band. On day 4, the leg is bent at the knee at a right angle.

To restore the strength of the quadriceps muscle, electrical stimulation and special simulators are used. Walking is allowed on the fourth day with crutches, and only in an orthosis. Every week the load increases by 25%.

The second phase of rehabilitation begins from the second week after the operation. The patient is allowed to exercise the joint by performing squats and leg abduction to the side in a straightened and bent position. With increased swelling and pain in the knee area, the load is again reduced.

The main exercises are carried out on flexion-extension of the knee. In the third and fourth phases of recovery, training is carried out to strengthen all the muscles of the limb, restoration of symmetrical load (right-left leg). After 4 weeks, it is allowed to walk without an orthosis and crutches if the functionality of the quadriceps muscle is restored.

Medical procedures include massage, physiotherapy, salt baths, taking vitamin complexes. Massage is carried out in the direction of the lymph (bottom-up) from the foot to the knee. The injured area is not massaged in the first weeks after the operation.

Doctors warn about the inadmissibility of exceeding loads during the passage of postoperative rehabilitation. Firstly, it can lead to rupture of the graft tissue, and secondly, it can upset the balance of the ligamentous apparatus. A second operation will be required, which is not always successful.

A long period of pain persisting after surgery is a sign of pinching of the nerve endings, tight extension of the knee indicates excessive tension on the graft. It is necessary to notify the surgeon of discomfort and discomfort so that appropriate measures are taken to eliminate them.

It is unacceptable to increase the angle of flexion, if this is not provided for by the rehabilitation program. Recovery after an injury is different for everyone (this also applies to personal feelings and the length of the rehabilitation time). The recovery period does not affect the final result in any way, but only indicates the different capabilities of the body.

Video: early rehabilitation after anterior cruciate ligament injury - part 1

Video: early rehabilitation after anterior cruciate ligament injury - part 2

Operation cost

Urgent surgery is performed free of charge (if the patient was admitted to the ambulance after an injury). The task of the surgeon is to carry out emergency diagnostics, remove blood from the joint cavity, stitch together the ligaments, or fix the limb (gypsum, plastic). Urgent assistance is aimed at eliminating factors that threaten human life and health. In steel cases, the operation is paid.

A planned operation for the reconstruction of ligaments costs from 39 thousand rubles. The price depends on the chosen surgical technique, the scale of the injury, the status of the clinic, the conditions of stay (comfort). Rehabilitation is paid separately. Judging by the feedback from patients, most of whom are athletes, knee ligament surgery allows you to fully restore the functionality of the joint, lead an active lifestyle, and even play sports at a professional level.

Video: surgery for damage to the anterior cruciate ligament of the knee joint

Comrades in the "workshop", colleagues in the hobby, friends at work - this publication concerns our health. The author of the article is doc. Igor Frolov, the hope and support of our injured knees.. Read carefully and completely, there are a lot of words, but they are very useful……

Rehabilitation after reconstruction of the anteriorcruciate ligament.

Arthroscopic reconstruction of the anterior cruciate ligament (anterior cruciate ligament) is one of the most common knee plastic surgeries in skiers. There are several options for performing this operation. Here are the most common ones:

1. Type of graft: own tissues (autoplasty) from the tendon of the hamstrings, patellar ligament or tendon of the quadriceps femoris; donor tissues (alloplasty); synthetic materials.

2. Type of fixators: metal fixators (titanium alloy), absorbable (polymer).

So. This happened. The ski did not unfasten, the mountain turned out to be wayward, and the speed became uncontrollable. You were lucky, the slope where this happened was under the control of a specialized ski patrol service, and you were adequately transported and delivered. After the consultation and MRI examination, it became clear that the operation was necessary, and the feeling of instability of the knee joint took away the remnants of doubt. You are in an orthopedic clinic. The operation went well, and the rehabilitation period began.

In the modern sense, the recovery process is divided into several stages, where each new stage is carried out only if the goals set at the previous stage are achieved.

Stage one

The first stage will require patience and skill from you..

1-2 weeks.

Objectives: Reduce pain and swelling.

The first day, ice is applied around the knee joint and on the area of ​​postoperative wounds. The next few days after the operation, bed rest is prescribed, so that the "need" will have to be discharged into a duck or a vessel. The position of the leg is full extension, walking only on crutches, and it is impossible or undesirable to lean on the leg. In order to fix the lower limb, a cast, "splint" or "orthosis" is used, fixed in the position of full extension. At night, they are allowed to slightly loosen the fixation in order to reduce discomfort. In the area of ​​the knee joint, as a rule, there is swelling (this is a fluid that accumulates in the bags of the joint and periarticular tissues). She is not dangerous. The bulk of the work is done by physicians: wound dressings with antiseptics, joint puncture (often, but not always). If you are in the hospital before removing the sutures, then the first days prophylactic antibiotics are injected into the gluteal muscle (painkillers are also injected there). If you are on an outpatient basis, then all drugs are prescribed, as a rule, in tablets. Sometimes, at the discretion of the attending physician, anti-inflammatory and decongestant physiotherapy "on the spot" (magnet, UHF) is prescribed. From the second - third day, the leg hurts less, and you can begin to perform isometric contractions of the quadriceps femoris muscle in the position of full extension, flexion-extension in the ankle joint, raising and holding the leg. The duration of the exercises for several minutes throughout the day, as the pain. On the 10-14th day, as a rule, the stitches are removed. And remember - postoperative wounds cannot be wetted with water until the sutures are removed. So, you will have to take a shower in the “Z” position or tightly wrap your leg with improvised means. - awkwardness and, as a result, falls on crutches. For example, when, after lying for a long time, you decide to go to the toilet, where the wet floor has not yet dried (well, or just dizzy). Therefore, before you get up and go, sit on the edge of the bed for a while and come to your senses. And when using crutches, try not to rush and adjust them in height so that you feel comfortable.

Stage two

3-4 weeks

Objectives: fight against muscle weakness, control the muscles of the thigh and a smooth transition from walking with crutches to walking without additional support. To this end, the rigid fixation is replaced by an orthosis (semi-rigid or preferably "frame type") with a small angle of flexion. From crutches refuse as far as possible by a gradual load on the operated limb. A variant of a gradual transition is possible: crutches - a cane - walking without support. The main thing is that you feel confident. At this stage, gradual flexion / extension in the knee joint also begins. Exercises on the thigh muscles are already performed in a larger volume in a lying or sitting position. It is possible to use electromyostimulation of the thigh muscles, massage. General strengthening daily exercises are carried out at home or in the gym.

! Common problems at this stage- excessive load on the leg after the rejection of crutches and, as a result, the appearance of edema and pain. It is necessary to reduce the load and consult with your doctor. Topical application of ointments based on heparin and diclofenac is allowed. Stage II This stage is characterized by the beginning of a normal life. The leg no longer hurts, crutches are not needed, all the unpleasant attributes of treatment are already behind. But there is a nuance… 5-8 weeks Tasks: restoration of the full range of motion in the knee joint, increase in the strength of the thigh muscles. Restoration of the correct gait. The lesson is conducted by an instructor - methodologist. This is not always required, but it is desirable. It is very important at this stage to achieve a full range of motion. This is a key task of the entire recovery process and requires willpower. This is achieved by constant flexion and extension in the knee joint and, if necessary, physiotherapy (thermal procedures, massage, hydromassage, electromyostimulation, electrical neurostimulation). Moderate power loads are carried out daily on all muscle groups of the thigh and lower leg (in a sitting or lying position, using weights).

! Common problems at this stage: many people turn their attention to the still weak quadriceps femoris and turn their attention to its recovery. However, this is not true. This muscle tends to atrophy quickly, but its full recovery (with the formation of the corresponding “relief” and volume) does not occur in one month.

9-12 weeks

Objectives: to improve proprioception (deep sensitivity, sense of limb position in space), restoration of precise movements and static muscle strength. At this stage, the best place for recovery is the gym, with its numerous strength training equipment for all thigh muscle groups, as well as gyms with sports equipment. All exercises are performed in a lying or sitting position. Classes are held at least 3 times a week. The orthosis is usually replaced with a "soft" elastic knee brace.

Desire to start running and jumping. Beware of these wrong desires.

Stage three

13-16 weeks

Objectives: Improve muscle strength and endurance. At this stage, long-term exercises on an exercise bike, rowing simulator are possible. Complex coordinated exercises and exercises "balance", "lunges", squats are used. General physical training is increasing, classes are held in the pool. Classes are held 3-4 times a week for 2 hours.

! Common problems at this stage: Leave everything and wait for everything to recover by itself.

Stage four

Expansion and complication of physical activity.

17 - 24 weeks

The main task is to prepare the muscles for a long static and dynamic load. The load is carried out on strength, endurance and coordination in a vertical position with a gradual complication of locomotor reactions: walking backwards, in a semi-squat, running with acceleration and deceleration on a flat surface, jumping rope, cycling.

! Frequent problems at this stage- muscle and extra-articular pain. They often occur due to an unbalanced approach to training. It is important to pay due attention to the warm-up and stretching / relaxation exercises at the end of each session.

The most frequently injured part of the body in people leading an active lifestyle is the legs.

Cracks and ruptures of the ligaments of the knee joint prevent you from living a full life. Treatment in most cases is surgery, during which the torn ligament is replaced with a graft.

How long does rehabilitation take after anterior cruciate ligament repair?

Rehabilitation after plastic surgery of the anterior cruciate ligament of the knee takes from six months to a year.

Full recovery time is divided into two main periods:

  • Rehabilitation in a hospital– lasts up to 15 days;
  • Rehabilitation at home- lasts from six months to a year.

The rehabilitation period in the hospital is aimed primarily at the successful healing of damaged tissues.. Much attention is paid to anti-inflammatory and anti-edematous therapy.

For the first 12 hours after surgery, ice is applied around the operated knee.

For the next 24-48 hours, any activity of the knee joint is completely contraindicated. It is fixed with a plaster cast or orthosis. The leg should be elevated.

Starting from the 3rd day, it is allowed to get out of bed and move around with crutches without relying on the operated leg. This must be done with great care to avoid re-injury to the knee.

The stitches are removed as standard - on the 10-12th day of hospital stay.

It is important to know! With daily examination and treatment of sutures with antiseptic preparations, the doctor may prescribe additional drug therapy. These actions are aimed at reducing the risk of complications.

Features of rehabilitation after surgery at home

Rehabilitation after plastic surgery of the anterior cruciate ligamentat home last about six months.

This time is divided into several stages, since each stage has its own characteristics and recommendations.

Stage I

It lasts from 3 weeks to a month. The main recommendations for rehabilitation after anterior cruciate ligament repair remain unchanged.

Anti-edematous and anti-inflammatory drug therapy is preserved. Physical exercises are added to tone the muscles and develop the joints.

For this use the following exercises:


According to research, by exercising them alternately, the effectiveness of recovery increases.

Stage II

Lasts for the next month. The main feature of this stage is the gradual abandonment of crutches and the addition of strength exercises for all muscle groups to the existing ones.

Exercises can be performed with an instructor in the gym or by yourself at home.

Additional exercises are as follows:


Note! The main goal of this time period of rehabilitation is the development of the knee joint. By the end of the second stage, the range of motion of the operated leg should be maximum.

Stage III

Takes next 2 months. This stage of rehabilitation after anterior cruciate ligament plasty is characterized by regular exercise in the gym.

A systematic increase in the load will ensure a positive trend in the recovery process. An exercise bike, exercises on the "balance", various strength training equipment for all muscle groups will be useful.

Do not forget about the above exercises that were performed at home. Classes should be at least 3 per week for 1 hour.


Rehabilitation after plasty of the anterior cruciate ligament requires effort and a lot of time.

Rehabilitators advise combining strength exercises with cardio for more effective study of the muscle mass of both legs. This will help not only build up, but also develop endurance in the muscles.

Stage IV

The final stage of the rehabilitation course after plastic surgery of the anterior cruciate ligament of the knee joint. Lasts up to the 6th month inclusive.

The main emphasis is on exercises performed in the vertical plane (leg abduction with weighting, walking backwards, walking in a semi-squat). A warm-up at the beginning and stretching at the end of the workout are mandatory.

How to quickly and better build muscle mass of the operated leg

Due to the low activity of the prohibition of flexion of the operated leg by more than 90 degrees, its muscle mass is reduced, on average, by 20-30% compared to the healthy one.

That is why it is so important to devote enough time to strength exercises.

An integrated approach will help to build up the missing muscle mass faster.

Experts recommend in addition to visiting the gym, also go to the pool. Resistance exercises in the water (walking, pulling legs at the side) have a positive effect on the restoration of muscle mass.

The action of an electric current of a certain frequency on muscle and nerve tissues helps to reduce pain and spasms in the operated leg. Increases lymph flow, the rate of removal of toxins.

Necessary physical exercises during knee rehabilitation

There are quite a lot of physical exercises necessary during rehabilitation. Of these, the most common can be identified.

  • Resistance in the ankle. From a reclining position, leaning on your elbows, legs straight, lower your fingers down, then pull towards you;
  • Quadriceps workout. In a sitting position, the operated leg is straight. You should press your foot down so that the quadriceps muscle is tensed;
  • Elevation of the operated leg from different positions. From a reclining position (on the back, on the side), with support on the elbows, the leg rises to a certain height (from 15 to 35 cm), lingers at the top point and returns back;
  • Heel pull on a flat surface. The operated leg lies on a flat, firm surface. It bends slowly, while the heel does not come off the surface. The angle of flexion is determined by the rehabilitation period and is strictly agreed with the instructor;
  • Fitball exercises against the wall. The fitball is fixed between the back and the wall. In this position, squats (30 degrees) are done with both legs. After a few weeks, the exercise becomes more difficult. It is performed first with only one foot. First healthy, then operated;
  • "Balance" exercises. A brace is put on the operated leg. It is necessary to stand with both feet on the platform, raise the healthy one a little up. This position is held for 20 seconds or more. A prerequisite is that the supporting leg should be in a slightly bent form, not to stagger. If it is impossible to maintain balance, you should immediately stand on both legs. This will help avoid re-injury to the recovering limb;
  • Lungs jumping from foot to foot on a trampoline. To perform this exercise safely, you should stick your hands to the wall or in the presence of an exercise therapy instructor.

Exercise therapy procedures, massage, hydromassage, swimming pool to speed up rehabilitation after surgery

During rehabilitation after anterior cruciate ligament plasty, one of the important components is the following procedures:

  • physiotherapy;
  • visiting the pool.

Together, all these actions greatly facilitate the recovery period.

Therapeutic massage improves tissue nutrition (swelling disappears faster, bruising resolves), helps to cope with muscle atrophy (if any).

Hydromassage calms the nervous system, helps muscles relax. This procedure is especially effective after exercise in the gym.

Why is diet important during knee rehabilitation?

A special role in the restoration of the knee, during rehabilitation, is the correct diet. Weight must be carefully monitored.

Extra pounds are an additional burden on the operated knee and the body as a whole.

Nutritionists in this situation are advised to reduce the consumption of carbohydrates. You can make up for this by eating more protein. You should also eat more vegetables and fruits.

Attention! Limit the use of salt in cooking. Excessive use of it leads to an increase in salt deposits in the bone tissue. This increases the risk of re-injury.

What is prohibited during the rehabilitation period of anterior cruciate ligament plasty

The main prohibitions throughout the entire rehabilitation period after anterior cruciate ligament plasty are:

  • any active and sharp flexion of the operated knee more than 40 degrees;
  • activities such as dancing, biking, skiing, snowboarding. Any sports.

During rehabilitation, if you have any questions, you should contact a traumatologist. His recommendations will be quite subjective for each patient and the stage of recovery they are in.

However, there A few general tips that a traumatologist will tell any patient:

  • Sports and balanced nutrition;
  • Long walks in the fresh air;
  • Sunbathing for additional production of vitamin D, without which the absorption of calcium in the bones is impossible;
  • Sleep at least 8 hours.

This video will tell you about rehabilitation after anterior cruciate ligament repair:

From this video you will learn about recovery after ACL rupture:

Injury to the anterior cruciate ligament (ACL) is a fairly common occurrence. The knees are very vulnerable to various injuries and injuries, since most of a person's weight falls on them. A knee injury leads to damage to the muscles and ligaments that are nearby, which complicates diagnosis and treatment.

Characteristics of PCS

The anterior cruciate ligament is one of the most important ligaments that provide stability to the knee joint. With its help, the anterior part of the articular surface of the tibia is connected to the posterior part of the intercondylar surface of the lateral condyle of the femur.

The ligament prevents excessive displacement lower leg forward relative to the thigh. The nerve endings that are in it, in response to changes in the position of the joint and the load, signal the muscles that stabilize the knee. Thus, the anterior cruciate ligament prevents instability and dislocations when running, walking, dancing and jumping, that is, in all situations when the direction of movement suddenly changes.

A rupture of the anterior cruciate ligament can occur with a sharp sudden twisting, flexion or extension of the knee, landing from a jump, or as a result of a blow to the shin or knee.

It is important to remember that engraftment in the knee joint occurs within three months after surgery. The new ligament during this period is very weak and vulnerable. Care must be taken not to overload. You can not jump, run, dance, squat deeply, kneel.

The operation to restore the knee joint itself takes a little time. If it is performed by an experienced surgeon, you can be sure of a good result and a quick postoperative recovery.

Longer recovery time after ACL plastic surgery, because the surgical intervention strongly affects the adjacent ligaments and muscles.

The main stages of treatment after surgery

At the end of the operation, the patient is placed in a ward equipped with special facilities that help the person recover. An ice pack is applied to the knee joint to reduce pain and prevent swelling. Rehabilitation after plastic surgery of the knee joint is most often carried out in specialized centers.

After the operation, the knee joint is fixed with a plaster bandage, which keeps the limb in the correct position and does not allow it to limply make various movements. This bandage should be on the leg for about a month., depending on the speed of muscle fusion and the anatomical features of the knee. The simplest physiotherapeutic treatment is jointly prescribed:

  • baths with hydromassage;
  • applying heat to the damaged surface;
  • limb massage;
  • trituration;
  • gymnastics.

In the postoperative period for a period of 1-14 days, it is necessary:

The first time after surgery, it is important to prevent the occurrence of thromboembolic complications. This is facilitated by physical exercises:

  • active foot movements. Bend and unbend every two hours 30 times;
  • voluntary tension of the anterior and posterior thigh muscles ten to fifteen times for 5 seconds every two hours.

It is forbidden during this period to walk, leaning on a half-bent leg, and actively unbend the lower leg in the knee joint.

Often, after removing the bandage, it is found that the limb is slightly hyperemic and swollen. In addition, if the bandage was too tight, pressure ulcers of the knee protrusions may form, and then tissue death. Given these factors, it is important to apply a fixing bandage correctly so that there are no complications after ACL plastic surgery.

Rehabilitation

For a month, when the leg is in a fixed position, the cartilage tissue is partially restored, the muscle strength of the knee begins to resume. However, it should be borne in mind that after a long stay of the limb in a certain position, it will be necessary to re-shape the joint under the bend angle in which it was before the operation.

For this reason, after the knee is released, the physiotherapy treatment is repeated with certain changes. The procedures will focus on keeping the knee in a stable position to relieve swelling. Also add therapeutic enhanced forced physical education.

In addition, the shock sound wave method is used, which is intended to stimulate the processes of osteogenesis: the resumption of the previous functions of the bone structure and its restoration. This therapy is based on the method of treatment with the help of acoustic waves, which, penetrating deep into the vessels, muscles and tissues, contribute to the rapid healing of wounds located on the surface and under the skin. This procedure is carried out no more than twice a week - as many times as the doctor recommends.

The listed recovery methods are carried out within four months. In this case, it is necessary to bend and unbend the knee strictly at a certain angle. When bending, the angle should not be more than 90 degrees. This is important to avoid re-injury.

Building muscle mass

The next stage of rehabilitation treatment after reconstruction of the knee joint is muscle building. During this period, it is necessary to ensure that the muscles and the entire limb as a whole do not atrophy. Therefore, UVT and exercise therapy are prescribed with an increased load on the joint.

Approximately 35% of healthy muscles are lost due to hip surgery on the affected leg. They need to be increased. If this is not done, the volume of a healthy thigh will be 25% larger than the volume of the patient. Such a deformation often causes even more difficult situations regarding the muscles of the sore leg. They will weaken, gangrene and necrosis may develop.

The most effective method of building and strengthening muscles is swimming. You can walk on the bottom of the pool or do exercises in the water.

The final stage of rehabilitation

The last rehabilitation stage begins after the fourth month from the day of the operation. The leg during this period is already quite well developed, and the range of motion is more or less stable. For the final recovery, the main condition is the continuation of exercise therapy and the growth of muscle mass in the femoral part of the injured limb.

Excellent treatment for joints- baths with hydromassage. They give good dynamics and calm the nervous system. A positive effect will give a stay at sea. Salt water helps to remove pain and draws out various suppurations, if any of them suddenly occur.

It is necessary to strictly follow the diet so as not to gain excess weight. Every six months, you should visit a doctor until the cruciate ligament is fully restored. Within two years, it is necessary to undergo a scheduled inspection and diagnostics.

I've had surgery on my right knee a couple of times. In his youth, he played football professionally. The first injury was terrible: a rupture of the knee joint capsule, a complete separation of the ACL, the destruction of the lateral and medial menisci, a tear in the hamstring and sprain of the lateral ligaments of the knee joint. In CITO, they collected it in parts somehow, but I could not recover normally and reach the previous level - I finished with serious sports. After - he played, as they say, "for himself", but after a couple of years he relapsed again. He looked like something, lay down, began to live a quiet life until he began to block the joint. I went to CITO to operate on the meniscus. They operated on, cleaned the menisci, but during arthroscopy they diagnosed that the ACL was torn off again, and while I was lying down at home, the ligament "soldered" to the posterior cross, so the rupture was not diagnosed before the operation on ultrasound. In the end, this is how I live. The joint is unstable in torsion. There is a rotation. There was even a relapse three years ago, which brought me to the surgeon's table for a puncture of blood from the knee joint, BUT ... Again, I am not ready to operate on the ACL (a flight for at least six months to recover). I live quite a full life for myself, but with an eye on some sports that require a sharp change in direction of movement (football, tennis, etc., etc.), but at the same time I play them in a special anatomical brace (gently just I play without fanaticism).
Now for the BB. I am actively involved. Leg day is sacred. Initially, the surgeon said: "pump up the muscles - everything will work." So now I don't skip leg day. Today was just such a day. FULL RANGE Squats - 6 sets in Smith (extreme - 100 kg for 15 repetitions, before that I start with 50 in each approach, throwing 10 kg). Knee - I wrap it with an elastic bandage. Next, calves, then extensions (5 sets of 10-14 plates for 15 reps), leg press (in the fifth set 250 kg for 15 reps), and deadlift at the end (80 kg for 12 reps 5 sets). I quote the weights, the number of approaches and repetitions to understand what kind of work a "sports invalid" can do - it was with this diagnosis that I was decommissioned from the sport.
So don't despair! Just work. Start small, just intuitively trying to feel and look for that COMFORTABLE and SAFE weight that you work with. At first, in no case do not overload the joint - it is now "crystal". Also, try not to "parasite" by doing more work with your good leg. At first, ochkaya get a relapse, you automatically transfer the maximum load on a healthy joint, and this is a deliberate evil.
In short - good health to you this year. Don't despair and eat!