Ligament injuries and cartilage defects neglected in the initial stages, pose a problem later. Ligament tears such as ACL tear: PCL MCL/LCL injury mainly cause instability patients are troubled with daily activities including jogging, climbing stairs. brisk movements. exercise sporting both for recreation & professional. MRIs help in diagnosing the level of injury, grading of the ligament tear and need for the repair.Ligament reconstructions are minimally invasive arthroscopic surgeries. Where in the entire knee joint is addressed with 2 to 3 portals. The diagnostic soapy is done and the status of the meniscus, cartilage and ligaments are noted, Meniscal repair can be done with special implants such as fast ﬁx, meniscal cinch, etc. For complex tears partial/subtotal meniscectomy is advised.
For most ligament reconstructions. hamstrings tendons are used. The graft is secured with ultra-button/tightrope at the thigh end and bio screws at the legend. For short individuals, using tight ropes holding the graft with graftlink technique is used. With the advent of the instrumentation and new techniques in surgeries. rehab has been shortened and almost pain free. Patients are discharged in 36-48 hours, walk with a walker within 4-6 hours post-surgery can be non dependent in 2-4 weeks time, back to office in 4-6 week’s time, back to low energy recreational activity in 3-6 months and high energy sports in 6-9 months period.
The widespread use of technology has brought in a gigantic transformation in the field of medical sciences and healthcare. Technology has even made it possible for doctors to treat their patients in a virtual environment. The many inceptions that took birth in the surgical field have supplemented to the benefits of the patients. One such origination that constituted to the knee related surgeries is the Arthroscopic Surgery. The knee arthroscopy is a minimally invasive surgical technique, that allows orthopedic surgeons to assess the injury (joint) and repair any injuries without needing to fully open the joint.
Generally, MCL & LCL injuries occur at bone attachments and heal well with conservative management using braces.Mostly in the early stages of osteoarthritis or small cartilage loss/defects, physiotherapy and medications prevent further damage and enhance recovery In certain macs, debridement and latest procedures like stem cell therapy (PRP/BMAC) are used. Post MRI arthroscopic debridement is done if required. For lesions approx less than 5mm and partial tears PRP lions enhance healing In cases unto 10mm lesions, PRP along with ﬁbrin glue stick the cartilage defect and allow it to heal. Knee can be bent immediately aﬂer the procedure. In case weight bearing area is involved. Weight bearing is delayed by 3-4 weeks. For large cartilage defects 16 cm, depending on the area of involvement OATS (Osteoarticular Transfer System/Osteochondral Autograft Transplantation) is done. Smaller might bearing portions of the knee to retain best functionality and biologics If the graft of cartilage is not sufficient for transfer, it is grown in labs and reimplantation.
If the meniscus tears, there is less protection for the knee bones and increased risk of developing arthritis.