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These injuries occur as a result of past sprains and dislocations of the knee joint, leading to post-traumatic instability of the joint. There are simple or complex instabilities, caused by damage to one or more ligaments of the knee joint.
Ligamentous damage should be treated surgically in most cases. Failure to do so leads to chronic instability, which, if left untreated, causes secondary damage to the other internal anatomical structures of the knee joint, most often in the form of cartilage damage. What is the solution? ACL reconstruction at the Silesian Sanvimed centre.
This is a very serious condition of the knee joint that can lead to disruption in the normal function of the joint and usually manifests itself as knee instability. Instability of the joint can manifest itself in a variety of ways and can lead to a reduced quality of life and an inability to participate in most sports. The underlying cause can be chondromalacia (softening of the articular cartilage), meniscus damage or recurrent effusions, manifesting as swelling of the knee joint. Untreated instability can lead to degeneration of the knee joint.
The menisci are fibrocartilaginous structures with a crescent shape. They are damaged due to severe torsional trauma to the knee, which often occurs in sport and is sometimes combined with damage to ligaments and articular cartilage. The second reason can be overload or degeneration. Here, damage to the meniscus occurs as a result of cumulative overload, micro-trauma and pathological abnormalities in the morphological structure of the meniscus.
The following surgical procedures are possible in cases of meniscus damage:
The type of procedure is decided by the surgeon, after prior agreement with the patient.
Damage to articular cartilage is often the result of instability or damage to the meniscus. They also arise as a result of intra-articular fractures, as well as direct trauma (contusions) to the knee. Cartilage also degrades as a result of osteoarthritis, rheumatic and other diseases. The most common contributor to articular cartilage disease of the knees is being overweight. Damage to articular cartilage is a major therapeutic problem. Being a noble tissue, cartilage does not undergo a regenerative process, but only scarring processes that lead to the filling of defects with cartilaginous connective tissue. Both surgical treatment and appropriate rehabilitation play a major role in its treatment.
The above-mentioned conditions of the knee joint, such as damage to the meniscus, ligaments and articular cartilage, are treated, among other things, arthroscopically.
Arthroscopy is a very modern and minimally invasive method of joint surgery. It involves inserting a camera into the joint cavity - from a small 0.5 cm incision - which transfers the image onto a monitor screen. This makes it possible to insert surgical instruments from separate small incisions in the skin and perform repair surgery.
The most common conditions treated arthroscopically are damage to the meniscus and ligaments of the knee joint. We also perform repair and reconstruction procedures of damaged structures using modern instrumentation. This makes it possible to sew the meniscus together, as well as to perform an arthroscopic ACL reconstruction - the anterior cruciate ligament - using an autogenous graft made from harvested tendons of the semitendinosus and semimembranosus muscles.
A separate group of conditions that qualify for treatment using the arthroscopic technique are damage to the articular cartilage and incipient osteoarthritis. In these cases, we use the technique of elaborating the defects by microfracturing and aligning the "shaving", the damaged joint surface. The resulting scar at the site of the damaged articular surface replaces the damaged articular cartilage, restoring joint function.
Length of stay:
The hospital stay lasts an average of one to two days and ends with initial rehabilitation to enable walking on crutches.
After treatment:
Following ACL reconstruction, the patient remains under constant follow-up at the hospital's orthopaedic clinic, from where he is referred to the rehabilitation centre.
Waiting time:
The waiting time for surgery varies from 2 to 3 weeks.
Knee endoprosthesis involves a total joint replacement, i.e. replacing the natural joint with an artificial one - an endoprosthesis. The procedure restores the lost function of this joint and allows basic movements such as walking, lifting weights. It is the only method that allows walking without experiencing pain.
Most knee joint endoprostheses consist of three main components: two titanium components, implanted on the bone socket, and a third in the form of an inlay, a high-quality plastic material. These prostheses differ essentially only in their method of attachment to the bone and are therefore distinguished between cemented prostheses, which are fixed on cement similar to a „dental filling”, and cementless prostheses, which are implanted by wedging and subsequent bone ingrowth. In many cases, poor mechanical strength of the bone makes it impossible to implant a cementless prosthesis.
In our centre, we perform both types of endoprosthesis procedures after the patient has been orthopaedically and anaesthetically qualified. We implant endoprostheses from the American company SMITH & NEPHEW and the BIOMET company.
The hospital stay lasts an average of five to 10 days and ends with initial rehabilitation to enable walking on crutches.
Following surgery, the patient remains under constant supervision at the hospital's orthopaedic outpatient clinic, from where he is referred for a three-week course of improvement treatment at a renowned rehabilitation centre.
The waiting time for surgery varies from 2 to 4 weeks.
The usual material used for ligament reconstruction is the patient's own tissue (ligamentous or tendinous), which is taken by making a small incision in the area of the operated knee joint. Most commonly, tendons of the semitendinosus and semimembranosus muscles are used. The harvested graft is inserted into pre-prepared holes in the tibia and femur and fixed with anchors, interference screws or other implants. On the first day after the operation, you can start walking on crutches without putting weight on the operated limb. Once the drains are removed, you can start walking on crutches with a stabiliser in place and with partial weight bearing on the operated limb. The knee drains are usually removed on the second postoperative day. Immediately after removal of the drains, rehabilitation is started.
After ACL (anterior cruciate ligament) reconstruction surgery, the patient is discharged home on the 2nd or 3rd day after surgery.
It is important to use a knee brace to protect the knee from excessive strain until the doctor authorises its removal. The time to return to normal activity depends on the type of work performed and ranges from 6 to 12 weeks. A return to sporting activity, on a limited basis, is possible after 4 months.
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