Operative therapy of the posterior cruciate ligament injuries
In case of fresh injuries the suture is promising and careful for the affected patient. In chronic cases the replacement with combined semitendinosus and gracilis tendon is the choice of treatment.
In case of chronic and strong posterior instabilities, sideband instabilities (in- or outside) frequently exist, which have to be treated during a replacement. In this case it can happen, that maybe a tendon oft he leg not affected has to be used as well.
Cruciate ligament injuries of elderly persons
Cruciate ligament injuries of elderly persons appear more seldom and they are only a reason for a surgery in case of a corresponding degree of activity. The primary therapy is the immobilization and muscle development (physical therapy). If the instability remains, a replacement makes sense due to the rapid progression of an arthrosis (joint deterioration).
Cruciate ligament injuries of children and adolescents
Childish cruciate ligament injuries are more seldom and thus they are often overlooked during the primary diagnosis. In case of continuous complaints the clarification with the specialist and an MRT scan are important. If combined injuries require an early surgery, the children are first of all sedated with a splint (orthosis), so that the cruciate ligament has the chance to heal (this is successful in 50% of the cases). 6 to 8 weeks after the injury a new clinical examination takes place and another one after approx. 3 months. If the knee joint remains instable, the early surgery is recommended both to parents and the child, as due to the high activity potential of children additional injuries of the menisci and of the cartilage can appear very quickly. A rapid and early destruction of the knee joint would be the consequence.
50% percent of the surgical success is achieved with the following rehabilitation and physical therapy. Only via this postoperative therapy specifically adjusted to the injury and surgery full mobility, muscle power and coordination are regained. Thus, an intense cooperation between the physiotherapist and surgeon like in our knee centre is extremely helpful and important.
After the surgery every patient receives a customized instruction for the most important behavioral safeguards after the surgery and for the following rehabilitation.