It turns out that there are four treatments for knee ligament injuries

In daily life, people often encounter small accidents of one kind or another during exercise, which affect their health. Knee ligament injury is one of them, which seriously affects people's activities. So how should knee ligament injuries be treated? Most people don't really understand this. In fact, the treatment methods for knee ligament injuries vary according to the location of the injury, and can be roughly divided into the following four types.

1. Treatment of knee ligament injuries

1. Medial collateral ligament injury: Sprain or partial rupture of the medial collateral ligament (deep layer) can be treated conservatively with long-leg tubular plaster fixation for 4-6 weeks. Complete rupture should be repaired as soon as possible. If there is meniscus injury and anterior cruciate ligament injury, they should also be treated at the same time during surgery.

2. Injury to the lateral collateral ligament: Patients with rupture of the lateral collateral ligament should undergo immediate surgical repair.

3. Anterior cruciate ligament injury: Any anterior cruciate ligament rupture that is less than 2 weeks old should be sutured surgically. If the ligament is broken, it is best to transplant a tendon to enhance the stability of the cruciate ligament. Generally, the middle 1/3 of the patellar ligament is selected as the transplant material. For partial rupture, the broken part can be sutured and then immobilized with plaster for 4-6 weeks. Currently, it is advocated to perform ligament suture surgery under arthroscopy.

4. There has been controversy in the past about whether the ruptured posterior cruciate ligament should be sutured. Current opinions tend to favor early repair under arthroscopy.

2. Diagnosis and examination methods of knee ligament injury

1. Lateral stress test Lateral stress test is very painful during the acute phase. You can wait for a few days or perform the operation after local anesthesia at the painful point, and perform passive knee varus and valgus movements with the knee joint fully extended and flexed 20 degrees to 30 degrees, and compare with the opposite side. If there is pain or it is found that the varus and valgus angles are beyond the normal range and there is a bouncing feeling, it indicates a sprain or rupture of the collateral ligament.

2. Drawer test: The knee joint is flexed 90 degrees and the calf is hanging down. The examiner holds the upper part of the tibia with both hands and pulls it forward and pushes it backward, paying attention to the forward and backward movement of the tibial tuberosity. Increased forward movement indicates a rupture of the anterior cruciate ligament. Increased posterior displacement indicates a rupture of the posterior cruciate ligament. Since the tibia can also have slight anterior-posterior passive movement when the knee is flexed to 90 degrees in a normal knee joint, it is necessary to compare the healthy side with the affected side. When the anterior cruciate ligament is ruptured alone, the anterior displacement of the tibia is only slightly greater than normal. If the anterior displacement increases significantly, it means that the medial collateral ligament may also be injured. The drawer test is very painful during the acute phase. It should be performed after anesthesia.

3. Pivot shift test: This test is used to treat knee instability that occurs after the anterior cruciate ligament is stretched. The patient lies on his side, and the examiner stands on one side, holding the ankle with one hand and flexing the knee to 90 degrees. Use the other hand to apply force on the outside of the knee to put the knee in a valgus position, then slowly straighten the knee joint until it is flexed to 30 degrees and you feel pain and bounce, which is a positive result. This is mainly because in the flexed knee valgus posture, the lateral tibial plateau is dislocated forward, the lateral femoral condyle slides to the back of the tibial plateau, and the lateral femoral condyle is suddenly repositioned during extension, causing pain.

Imaging examination and arthroscopy: Plain X-ray examination can only show the avulsed fracture fragments. In order to show whether there is any injury to the medial and lateral collateral ligaments, a stress position radiograph can be taken. That is, the X-ray is taken in the knee varus and knee supine positions. This position is very painful and needs to be performed after local anesthesia. The opening of the medial and lateral gaps is compared on the X-ray film. It is generally believed that a difference of 4mm between the two sides indicates a mild sprain, 4-12mm indicates a partial rupture, and more than 12mm indicates a complete rupture, which may also be accompanied by anterior cruciate ligament injury.

MRI examination can be clear. It shows the condition of the anterior and posterior cruciate ligaments and can also detect hidden fracture lines.

Arthroscopy is important in diagnosing cruciate ligament injuries. Anterior cruciate ligament injury can be found in 75% of acute traumatic hemarthrosis, of which 2/3 of the cases are accompanied by medial meniscus tear and 1/5 have articular cartilage defect.