Lots of people get injured in the knees while exercising.
How is it handled?
A tear in the meniscus and a tear in the anterior cruciate ligament are sports injuries that will usually require surgical treatment.
Dr. Yohanan Horev, an orthopedic surgeon and director of the Knee Surgery and Sports Injury Unit at Laniado Hospital, explains how it works and what the success rates are
Dr. Yochanan Horev, in collaboration with zap doctors
27/03/2022
Sunday, 27 March 2022, 10:41 Updated: 10:49
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The practice of sports as a way of maintaining health is recommended at any age, but is conditional on its adaptation to the basic physical ability of each and every person, depending on his or her age and medical condition.
Contrary to popular belief, controlled exercise does not erode the cartilage of the knee joint but rather - physical activity is a positive factor for all components of the knee joint (cartilage, ligaments and menisci) and overall function.
Most sports injuries to the knee joint are treated with a conservative approach, with the exception of sports injuries such as a meniscus tear and a tear in the anterior cruciate ligament, which require relatively high surgical treatment.
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Tear in meniscus
Causes and Symptoms
A tear in the meniscus can be caused by cumulative damage or as a result of a sharp injury.
There is a possibility of combining the two mechanisms - a rupture caused by a relatively minor injury to a weakened meniscus section from previous cumulative damage.
Common symptoms of meniscus rupture are pain, restriction of movement, ejaculation (leakage of synovial fluid) and knocks in the knee joint.
The symptoms appear with the strongest intensity in the vicinity of the event and decrease over time or pass, but intensify again back to activity.
Common treatment methods for meniscus rupture
The initial treatment for meniscus rupture is usually conservative and includes painkillers and anti-inflammatory drugs, activity limitation and physical therapy.
In acute cases that involve locking of the knee joint, there is an indication for early surgical treatment.
Surgical treatment is offered on the condition that the symptoms do not go away or reappear in any attempt to return to sports activities.
Surgical treatment for a meniscus tear is minimally invasive: arthroscopy through two five-millimeter incisions in the front of the knee.
The operation is performed as part of a day hospitalization and lasts about 15 minutes.
The course of arthroscopic meniscus rupture
surgery The type of arthroscopic surgical treatment for meniscus rupture is determined by the size and location of the rupture: if the ruptures are located around the meniscus, they can be sutured, and if the rupture is at the margin of the meniscus, limited local resection of the ruptured meniscus.
It should be emphasized that the protection of the meniscus on the articular cartilage surfaces is reduced by only a limited amount due to the limited resection.
A tear in the meniscus can be caused by cumulative damage or as a result of a sharp injury.
Orthopedic examination (Photo: ShutterStock)
Return to sports activities after repairing a meniscus tear
After repairing a meniscus
tear, there is no prohibition to return to sports activities. Return to activity varies depending on the type of surgery:
.
After about a week he will be able to return to athletic walking, and after two to three weeks he may start running and gradually return to full sports activity.
- In cases of meniscus suturing, treading is limited to six weeks in order to protect the healing process of the sutured section.
After this period of time, you can gradually return to sports activities.
Rupture of the anterior cruciate ligament
Causes and Symptoms
A rupture of the anterior cruciate ligament is caused by a rotational injury, usually during running or jumping, as opposed to a rupture of the meniscus that can also be caused without an injury (degenerative rupture), since a rupture of the anterior cruciate ligament is caused by obvious acute injury.
The symptoms that accompany the rupture of the cruciate ligament are likely to pass over time, but there may be a fear of returning to sports activities due to a feeling of insecurity and instability.
There may also be recurrent tripping of the knee joint when performing a sharp movement, whether walking or descending stairs or attempting to return to sports activities that involve changes of direction or jumps.
When is it recommended to analyze the rupture of the cruciate ligament?
Surgical treatment is designed to prevent recurrent trials of the knee joint because they cause cumulative damage and over-structure of the knee joint, menisci and articular cartilage.
Surgery can be avoided if there are no recurrences and the patient is not expected to return to sports activities that include running and jumping.
The course of surgery to restore anterior cruciate ligament
A tear in the anterior cruciate ligament cannot be self-healing or sutured, so it is necessary to reconstruct the ligament with arthroscopy surgery without opening the knee joint.
Recovery to the cruciate ligament comes from two sources - the first from the patient's body and the second from the tissue bank.
In the first case, the tendon implant is usually taken from the hamstring through a short surgical incision about three inches near the knee or from a tissue bank.
I will emphasize that taking the tendon implant from the knee ligament does not impair the future function of the knee joint, but the course of this surgery is longer because it includes the tendon harvesting phase and making a larger insertion incision.
The use of a tendon implant from a tissue bank further reduces the scope of the surgery and shortens the recovery time, as there is no need to harvest the tendon and the insertion incision is small.
Contrary to popular belief in the past, it is now customary to offer surgery to reconstruct the cruciate ligament at any age in cases of repeated stumbles and when one wants to return to high-intensity sports activities that include running and jumping.
Rehabilitation process after surgery to restore the anterior
cruciate ligament The reconstructed cruciate ligament and the fixations at its ends are strong enough and durable even in routine activities, so you can step on and walk the day after surgery even without crutches and without limiting the range of motion of the knee joint.
It is recommended to start with physiotherapy treatment which is mainly based on self-activation, and this is because the implant strengthens over time.
You can run again after three months from the day of surgery, and you can participate in ball games and even return to full athletic activity after six months.
The author is Dr. Yohanan Horev, an orthopedic specialist with orthopedic specialization
and knee surgery, established and heads the Knee Surgery and Sports Injuries Unit at Laniado Hospital.
In addition, contact: dr.chorev@gmail.com
Beit Giron Clinic, Raanana, Tel: 09-7713026. Hours of operation: Sunday, Tuesday, Wednesday, Thursday, 20: 00-16: 00
Beit Gedi Clinic , Netanya, Tel: 098618081. Telephone answering: Sunday-Thursday, 20: 00-08: 00, Friday, 12: 00-08: 00
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