Anterior cruciate ligament injury is a common sports injury of the knee joint, commonly seen in the process of sports jumping and landing knee sprain, the injury can feel the joint wrong feeling, and sometimes you can hear a pop, after the injury due to intra-articular hemorrhage will be obvious swelling of the joints, according to statistics, knee sprain accompanied by intra-articular hematoma, anterior cruciate ligament injury will be as high as 70% of the incidence of the injury. After the injury, the patient's joint movement is limited and walking is difficult. If you use four keywords to summarize the clinical manifestations of the acute phase after ACL injury, it is "ringing, pain, swelling, limitation". ACL injuries may also be associated with meniscus and/or collateral ligament injuries, which may have other combined clinical manifestations.
Anterior cruciate ligament rupture, if more than 3 weeks and untreated, will gradually turn into the chronic phase, the chronic phase of the symptoms of the knee joint instability, playing soft legs, and the feeling of joint misalignment in sports. Long-term untreated meniscus can lead to meniscus tears and symptoms of interlocking joints.
In the acute stage, if the joint swelling is obvious and painful, you can apply ice and go to the hospital as soon as possible for diagnosis and treatment. The current hospital examination technology is very convenient for diagnosing ACL injury. Knee MRI can clearly see the ACL and also observe the damage of meniscus and articular cartilage.
Anterior cruciate ligament injuries are usually treated surgically if they are above II°. Conservative treatment is only suitable for partial ACL tears and for elderly patients who have a complete tear of the ACL but have a low demand for sports. It includes rest, ice, brace braking and functional rehabilitation. The treatment process consists of two steps: the first step aims to eliminate the inflammatory response and restore joint mobility and muscle control. Ice is usually applied to reduce pain and swelling, and joint mobility and patellofemoral movement can begin immediately, along with muscle strength training to avoid muscle atrophy. Step 2 can be started once the patient has regained a normal gait. The second step is to emphasize hamstring and quadriceps strength training with open and closed chain exercises. Balance training and proprioceptive training are then performed. Conservative treatment should involve the use of a functional brace, which provides all-around stabilization of the knee and allows a range of motion in patients with ACL injuries.
Surgery should be considered for patients with complete ACL rupture, combined meniscal or other ligament injuries, participation in high-level sports, and younger patients. The approach is arthroscopic ACL reconstruction surgery. The ACL can be reconstructed using either autologous or allogeneic tendons. For the timing of surgery for acute ACL injuries, doctors recommend surgery once the joint effusion has disappeared and joint mobility and quadriceps strength have returned. Functional exercises such as straight leg raising can be started on the 2nd to 3rd day after the surgery, and at the same time, passive knee flexion and extension activities can be practiced, and the knee can be moved within the range of 0° to 90° for 4 weeks, and recovered to normal in 6 to 8 weeks. After surgery, a brace should be worn for 6 weeks for protection, and the affected limb can be partially weight-bearing under the protection of the brace. After recovering to be able to walk normally, you can start stationary bicycle, lower limb muscle strength recovery exercise. Three months after the operation, you can start running and jumping exercises, six months after the operation, you can resume simple sports, and one year after the operation, you can basically resume normal sports activities.
The cost of arthroscopic reconstruction of the anterior cruciate ligament (ACL) varies depending on the material used and whether a double-bundle reconstruction or a single-bundle reconstruction is used. For example, a single-bundle reconstruction with an autologous tendon costs about 25,000 yuan, a double-bundle reconstruction about 35,000 yuan, and the use of an allograft ligament about 50,000 yuan. These are all full hospitalization and surgical costs.