Ligament Repair
When ligaments are damaged, the knee joint may become unstable. Ligament damage often happens from a sports injury. A torn ligament severely limits knee movement. This results in the inability to pivot, turn, or twist the leg. Surgery is a choice to repair a torn ligament if another medical treatment is not effective.
Risks
Joint
replacement
How you prepare
Joint
replacement
What you can expect
Joint
replacement
Results
Joint
replacement
The most common reason for knee replacement surgery is to relieve severe pain caused by osteoarthritis. People who need knee replacement surgery usually have problems walking, climbing stairs, and getting in and out of chairs. Some also have knee pain at rest.
Knee replacement surgery, like any surgery, carries risks. They include:
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Infection
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Blood clots in the leg vein or lungs
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Heart attack
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Stroke
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Nerve damage
Signs of infection
Notify your doctor immediately if you notice:
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Fever greater than 100 F (37.8 C)
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Shaking chills
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Drainage from the surgical site
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Increasing redness, tenderness, swelling, and pain in the knee
An infected knee replacement usually requires surgery to remove the artificial parts and antibiotics to kill the bacteria. After the infection is cleared, another surgery is performed to install a new knee.
Artificial knees can wear out
Another risk of knee replacement surgery is failure of the artificial joint. Daily use wears on even the strongest metal and plastic parts. Joint failure risk is higher if you stress the joint with high-impact activities or excessive weight.
Food and medications
Your doctor or anesthesiologist might advise you to stop taking certain medications and dietary supplements before your surgery. You'll likely be instructed not to eat anything after midnight the day of your surgery.
Prepare for your recovery
For several weeks after the procedure, you might need to use crutches or a walker, so arrange for them before your surgery. Make sure you have a ride home from the hospital and help with everyday tasks, such as cooking, bathing and doing laundry. If you live alone, your surgeon's staff or hospital discharge planner can suggest a temporary caretaker.
To make your home safer and easier to navigate during recovery, consider doing the following:
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Create a living space on one floor since climbing stairs can be difficult.
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Install safety bars or a secure handrail in your shower or bath.
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Secure stairway handrails.
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Get a stable chair with a firm seat cushion and back, and a footstool to elevate your leg.
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Arrange for a toilet-seat riser with arms if you have a low toilet.
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Get a stable bench or chair for your shower.
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Remove loose rugs and cords.
Before the procedure
Knee replacement surgery requires anesthesia. Your input and preference help the team decide whether to use general anesthesia, which makes you unconscious, or spinal anesthesia, which leaves you awake but unable to feel pain from your waist down.
You'll be given an intravenous antibiotic before, during and after the procedure to help prevent post-surgical infection. You might also be given a nerve block around your knee to numb it. The numbness wears off gradually after the procedure.
During the procedure
Your knee will be in a bent position to expose all surfaces of the joint. After making an incision about 6 to 10 inches (15 to 25 centimeters) long, your surgeon moves aside your kneecap and cuts away the damaged joint surfaces.
After preparing the joint surfaces, the surgeon attaches the pieces of the artificial joint. Before closing the incision, he or she bends and rotates your knee, testing it to ensure proper function. The surgery lasts about two hours.
After the procedure
You'll be taken to a recovery room for one to two hours. How long you stay after surgery depends on your individual needs. Many people can go home that same day. Medications prescribed by your doctor should help control pain.
You'll be encouraged to move your foot and ankle, which increases blood flow to your leg muscles and helps prevent swelling and blood clots. You'll likely receive blood thinners and wear support hose or compression boots to further protect against swelling and clotting.
You'll be asked to do frequent breathing exercises and gradually increase your activity level. A physical therapist will show you how to exercise your new knee. After you leave the hospital, you'll continue physical therapy at home or at a center.
Do your exercises regularly, as instructed. For the best recovery, follow all of your care team's instructions concerning wound care, diet and exercise.
For most people, knee replacement provides pain relief, improved mobility and a better quality of life. And most knee replacements can be expected to last more than 15 years.
Three to six weeks after surgery, you generally can resume most daily activities, such as shopping and light housekeeping. Driving is also possible at around three weeks if you can bend your knee far enough to sit in a car, if you have enough muscle control to operate the brakes and accelerator, and if you're not still taking narcotic pain medications.
After recovery, you can engage in various low-impact activities, such as walking, swimming, golfing or biking. But you should avoid higher impact activities — such as jogging, skiing, tennis and sports that involve contact or jumping. Talk to your doctor about your limitations.
4 major ligaments
Ligament Repair
When ligaments are damaged, the knee joint may become unstable. Ligament damage often happens from a sports injury. A torn ligament severely limits proper knee movement. This results in the inability to pivot, turn, or twist the leg. Surgery is a choice to fix a torn ligament if other treatment does not work.
The ligaments in the knee connect the femur (thighbone) to the tibia (shin bone). There are 4 major ligaments in the knee:
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Anterior cruciate ligament (ACL). This ligament controls the rotation and forward movement of the tibia (shin bone).
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Posterior cruciate ligament (PCL). This ligament controls the backward movement of the tibia (shin bone).
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Medial collateral ligament (MCL). This ligament gives stability to the inner knee.
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Lateral collateral ligament (LCL). This ligament gives stability to the outer knee.
Why might you need a knee ligament repair
Ligament Repair
The ACL is located toward the front of the knee. It's the most common ligament to be injured. The ACL is often stretched or torn during a sudden twisting motion (when the feet stay planted one way, but the knees turn the other way). Skiing, basketball, and football are sports that have a higher risk of ACL injuries.
The PCL is located toward the back of the knee. It's also a common knee ligament to be injured. But the PCL injury usually happens with sudden, direct impact, such as in a car accident or during a football tackle.
The MCL is located on the inner side of the knee. It's injured more often than the LCL, which is on the outer side of the knee. Stretch and tear injuries to the collateral ligaments are usually caused by a blow to the side of the knee, such as when playing hockey or football.
Early medical treatment for knee ligament injury may include:
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Rest
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Ice pack application (to reduce swelling that happens within hours of the injury)
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Compression (from an elastic bandage or brace)
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Elevation
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Pain relievers
A knee ligament tear may be treated with the following:
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Muscle-strengthening exercises
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Protective knee brace (for use during exercise)
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Activity limitations
Knee ligament repair is a treatment for a complete tear of a knee ligament that results in instability in the knee. This repair is done by an orthopedic surgeon, a surgeon who specializes in treating bone, muscle, joint and tendon problems. People with a torn knee ligament may be unable to do normal activities that involve twisting or turning at the knee. The knee may buckle or “give-way.” If medical treatments are not satisfactory, ligament repair surgery may be an effective treatment.
The surgery to correct a torn knee ligament involves replacing the ligament with a piece of healthy tendon. A tendon from the kneecap or hamstring, for example, is grafted into place to hold the knee joint together. The tendon graft may come from the person (autograft) or from an organ donor (allograft).
There may be other reasons for your healthcare provider to recommend a knee ligament repair.
Risk
Ligament Repair
As with any surgery, complications can happen. Some possible complications are:
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Bleeding
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Infection
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Blood clots in the legs or lungs
Some people may experience pain, limited range of motion in the knee joint, and occasional swelling in the knee after surgical ligament repair. Others have increased motion in the knee joint as the graft stretches over time.
There may be other risks depending on your specific health condition. Talk about any concerns with your surgeon before the procedure.
How do You get ready for a knee ligament repair?
Ligament Repair
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Your surgeon will explain the procedure to you and offer you the chance to ask any questions that you might have about the procedure.
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You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
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In addition to a complete medical history, your healthcare provider may perform a complete physical exam to ensure you are in good health before undergoing the procedure. You may undergo blood tests or other diagnostic tests.
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Tell your surgeon if you are sensitive to or are allergic to any medicines, latex, tape, and anesthetic agents (local and general).
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Tell your surgeon of all medicines (prescribed and over-the-counter) and herbal supplements that you are taking.
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Tell your surgeon if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medicines, aspirin, or other medicines that affect blood clotting. It may be necessary for you to stop these medicines before the procedure.
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If you are pregnant or think you could be, you should notify your surgeon.
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You will be asked to fast for 8 hours before the procedure, generally after midnight.
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You may receive a sedative before the procedure to help you relax. Because the sedative may make you drowsy, you will need to arrange for someone to drive you home.
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You may meet with a physical therapist before your surgery to discuss rehabilitation.
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Arrange for someone to help around the house for a week or two after you are discharged from the hospital.
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Based on your health condition, your healthcare provider may request other specific preparations.
What happens after a ligament repair?
Ligament Repair
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After the surgery, you will be taken to the recovery room for observation. Your recovery process will vary depending on the type of anesthesia that is given. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged to your home. Knee ligament repair is usually done on an outpatient basis.
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You may be given crutches and a knee immobilizer before you go home.
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Once you are home, it's important to keep the surgical area clean and dry. Your healthcare provider will give you specific bathing instructions. The stitches or surgical staples will be removed during a follow-up office visit.
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Take a pain reliever for soreness as recommended by your surgeon. Aspirin or certain other pain medicines may increase the chance of bleeding. Be sure to take only recommended medicines.
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To help reduce swelling, you may be asked to elevate your leg and apply an ice bag to the knee several times per day for the first few days. Your healthcare provider will arrange for an exercise program to help you regain muscle strength, stability, and range of motion. Physical therapy is a key part of recovery.
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Tell your surgeon if you have any of the following:
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Fever or chills
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Redness, swelling, bleeding, or another drainage from the incision site
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Increased pain around the incision site
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Numbness or tingling in the leg
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Calf swelling or tenderness
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You may resume your normal diet unless your healthcare provider advises you differently.
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Because of the limited mobility, it may be hard for a few weeks to resume your normal daily activities. You may need someone at home to assist you. You should not drive until your healthcare provider tells you to. Other activity restrictions may apply. Full recovery from the surgery and rehab may take several months.
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Your surgeon may give you additional or alternate instructions after the procedure, depending on your particular situation.
