Ligament Reconstruction and Repair

Ligaments are fibrous connective tissues that attach bones at the joints, and connect bones to bones. These are different from tendons, which connect muscles to bone. The main function of the ligament is to stabilize the joint by limiting movements that may result in excessive wear, instability or damage.

Ligament injuries are common sports injuries that happens when excessive pressure or stretching is applied on the joint beyond its capacity, causing the ligament to tear away from the bone. These frequently occur in athletes, with weight-bearing joints being the most commonly affected. Severity of the sports injury ranges from mild stretching to partial or complete tearing. Symptoms include swelling, joint instability and impaired function.

Treatment Options

Treatments for ligament tears depend on the severity and location of these injuries. For mild to moderate cases, rest, anti-inflammatory medicines, therapy and at-home care are enough to help the ligament recover after a few weeks. In some instances, a brace may be required to speed up the healing process. Complete tears, on the other hand, are major injuries that require therapy and surgery.

Among sports injuries, ligament damage in the knee is one of the most common. The knee is composed of four major ligaments:

  • Anterior cruciate ligament (ACL) - controls the forward movement and rotation of the shin bone (tibia).
  • Posterior cruciate ligament (PCL) - controls the backward movement of the shin bone (tibia).
  • Medial collateral ligament (MCL) - stabilizes the inner knee.
  • Lateral collateral ligament (LCL) - stabilizes the outer knee.

Among the four, ACL is the most debilitating and usually requires surgery for reconstruction.

In order to diagnose the severity of the injury and prescribe the most appropriate treatment, a sports surgeon or physician may perform physical exams such as the Lachman test to check the integrity of the ligament. Imaging tests like X-ray, ultrasound and MRI, and joint aspiration to detect inflammation and infections, may also be conducted.

Most ligament injuries can be treated using the PRICE method - Protect [from further injuries], Rest, Ice, Compression and Elevation - as well as prescribed antin-inflammatories or painkillers. For more serious cases, rehabilitation and surgery may be necessary. Tears that result in instability and impaired function of the knee are often repaired through a minimally invasive procedure known as arthroscopy.

During the operation, the surgeon will remove the damaged ligament and replace it with a tendon, either from the patient or from a deceased donor. This graft, which will be fixed in place, will act as a bridge on which fresh ligament will grow and assimilate (ligamentization). It takes several months for a new ligament to be fully reconstructed.

After the operation, a brace will be fixed on the affected area to protect it from further damage. At-home treatments can also help hasten recovery. Therapy sessions may be required, in which exercises are given to strengthen muscles and joints and improve their flexibility.

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