Brief overview
- Procedure: Cruciate ligament surgery is performed on an outpatient or inpatient basis, under general or partial anesthesia, with repair (ligament suture) or reconstruction (ligament reconstruction, transplant) of the cruciate ligament
- Follow-up treatment: Immobilization with splint, cooling, physiotherapy with muscle and coordination training, lymphatic drainage, painkillers
- Prognosis: The chances of recovery after cruciate ligament surgery are usually good. The healing process to almost full weight-bearing capacity takes several weeks to months. In some cases, complications such as bleeding, venous thrombosis or nerve damage may occur.
How does cruciate ligament surgery work?
In many cases, a cruciate ligament rupture can be treated without surgery. Doctors often opt for surgical treatment (cruciate ligament surgery) for athletes, for example, because this produces the best long-term results. During the procedure, the injured cruciate ligament is repaired (stitched, sutured) or replaced (reconstructed). There are various surgical techniques for this. Nowadays, surgeons perform cruciate ligament surgery almost exclusively using minimally invasive (arthroscopic) techniques.
Outpatient or inpatient
General or partial anesthesia
Depending on the extent of the procedure, the doctor will perform cruciate ligament surgery under either general or partial anesthesia. With a partial anesthetic, you are awake during the operation. However, the surgical area is anaesthetized so that no pain is felt. The operation takes one to two hours, depending on the technique, extent of the injury and the surgeon’s experience.
Cruciate ligament replacement (cruciate ligament plastic surgery)
Sometimes it is possible to simply stitch a torn cruciate ligament. In many cases (especially if the ligament is completely torn), however, a cruciate ligament replacement is necessary. There are basically three different types of transplant:
- Autograft: Another tendon from the patient is used to replace the torn cruciate ligament, for example a piece of the patellar tendon.
- Allograft: The graft is the tendon of a donor.
- Synthetic cruciate ligament replacement
How does the follow-up treatment work?
After cruciate ligament rupture surgery, the knee is usually stabilized in a splint (knee brace) for some time. These splints usually allow a gradual increase in the range of motion. Doctors refer to this as post-operative positioning, usually in an extended position. It is often necessary and beneficial for the healing process to cool the joint.
At the beginning of physiotherapy, a therapist mainly moves the knee passively as part of physiotherapy. This is followed by slow muscle development or muscle training and coordination exercises. The aim is for the knee to eventually regain its full range of motion and be sufficiently stable.
Individual aspects – especially sport-specific requirements (e.g. for professional athletes) – are also taken into account. In addition to the therapist’s qualifications, the patient’s motivation and cooperation are crucial to the success of physiotherapy after cruciate ligament surgery.
If pain still occurs after the operation, it can be treated with standard painkillers (anti-inflammatory drugs).
How long does recovery take after cruciate ligament surgery?
The aim of cruciate ligament rupture surgery is to maintain normal knee mechanics and stability with the best possible reconstruction. This works well in most cases. However, the surgical results for the posterior cruciate ligament are not as good as for the anterior cruciate ligament.
In cruciate ligament plastic surgery, an autologous tendon is usually used as a transplant so that no rejection reactions are to be expected. The healing process is usually problem-free. The transplant rarely tears or loosens after the operation.
When is sport possible again after cruciate ligament surgery?
There is no general recommendation as to when someone can return to their usual sport after cruciate ligament surgery. However, it usually takes several months. It is best for patients to clarify with their treating doctor when and to what extent it is best for them to return to sport.
A premature return to sport can lead to renewed injuries and failure of the cruciate ligament plastic surgery. It should also be borne in mind that the affected knee is more susceptible to re-injury once rehabilitation is complete.
