Pain after the operation | Aftercare of a cruciate ligament rupture

Pain after the operation

After surgery for a torn cruciate ligament, pain is a completely normal side effect of the healing process. (see: Symptoms of a torn cruciate ligament)Nevertheless, it is important to treat this pain sufficiently. It does not make sense to want to endure the pain.

Especially after operations and in the subsequent rehabilitation, it is important to be as pain-free as possible in order to be able to perform the strengthening exercises at all. If you are in too much pain, this not only prevents good physiotherapy but can also lead to relieving postures or, in the worst case, to the development of chronic pain. For pain therapy after surgery, typical painkillers that are also available over the counter, such as ibuprofen or diclofenac, are usually used. In addition to analgesic, these also have a decongestant and anti-inflammatory effect, which promotes healing after the operation. However, even with simple measures such as cooling, elevation and performing the prescribed exercises, the pain can often be reduced and the healing process improved.

The time schedule

Post-treatment scheme patellar tendon transplant 1st day positioning on foam splint, no load, isometric exercises hip flexors, abductors and knee extensors, active exercises healthy leg – cocontraction. 2nd day movement exercises active and passive 0-0-90, 1/2 body weight load, motor splint 2 x 1/2 hour daily, full extension, patella mobilization. up to 3rd week movement exercises active and passive 0-0-90, 1/2 body weight load, individual patient gymnastics with PNF, active movement therapy with resistance, cocontraction, stabilization and coordination exercises with partial load, strength training of the ischiocrural muscles, cryotherapy 5 minutes at the end of each exercise series.

4th to 6th week movement exercises active and passive 0-0-90, full load, increasing resistance during muscle training, coordination training, swimming pool, isokinetics, stationary bike.7th to 12th week Free range of motion, full load (everyday resilience usually reached after 8 weeks), treatment plus treadmill, coordination and skill training (tilt top, trampoline), exercise time 2 – 3 hours daily. From 13th week Free range of motion, full load, training according to demand and progress, isokinetic muscle training, bicycle, swimming. Avoidance of dynamic sports in the first postoperative year due to the risk of graft stretching!

Follow-up treatment scheme semitendinosus transplant 1st – 3rd day: Immobilization in a dorsal plaster splint or positioning splint in 15°-flexion (flexion)cryotherapy (cold therapy), isometric tension exercises 4th day: Immobilization in a dorsal plaster splint or positioning splint in 15°-flexion (flexion)cryotherapy (cold therapy), isometric tension exercises 4th day: Immobilization in a dorsal plaster splint or positioning splint in 15°-flexion (flexion) cryotherapy (cold therapy), isokinetic tension exercises Day 4: Fitting of the Don Joy Goldpoint orthosis with extension/flexion: 0-10-90°mobilization and gait training under full loadFirst physiotherapeutic exercise therapy according to PNF Day 7 – 8: Discharge of the patient if no complications occur. 11th day: Suture removal at the end of 6 weeks: Follow-up examinationRevocation of the 10° extension inhibition, Ext.Flex. of the orthosis: 0 – 0 – 90°the orthosis may be removed at night from 13th week: Follow-up examinationRemoval of the orthosis, avoidance of dynamic sports in the first postoperative year due to the risk of graft stretching!

The aim of the externally performed physiotherapy (physiotherapy) is also to achieve a knee joint flexion of 90°, an extension of 10° and after six weeks 0°, as well as strengthening of the muscles that stabilize the knee joint. The training of proprioception can be supported by training devices (mini trampolines). As soon as the patient reaches an active flexion of 90°, a movement training on a home bicycle could be carried out.

Jogging on level ground with the knee joint orthosis in place is approved at the earliest 12 weeks postoperatively, sports such as soccer, basketball, etc. only after one year has elapsed. Please also note the related topics: Torn ligament of the ankle joint. Further information can also be found in the Sports Medicine section.