Cruciate Ligament Operation

The athlete has suffered a knee injury; an injury to the anterior cruciate ligament has been diagnosed. To restore the stability of the knee, replacement of the anterior cruciate ligament is necessary.

Professional opinions diverge widely on the best surgical method and follow-up treatment. For this reason, several replacement possibilities are described here. The following materials can be used for cruciate ligament replacement:

  1. endogenous tissue (i.e. parts of the femoral tendon or a patellar tendon)
  2. foreign material (allografts - very suitable for re-operations)
  3. animal tissue (xenografts - still at the experimental stage)
  4. implants (uncommon because of the short lifetime)

The choice of material depends heavily on the requirements and circumstances of the particular case. As a result, it is not possible to make any universally valid generalizations. This is clearly a very individual decision requiring a personal conversation between the physician and patient.
For this reason, we can only describe a method here which we have used fairly frequently at our hospital. In total, we perform about 400 cruciate ligament operations of many different kinds each year.

For example, we sometimes use an about 9-mm-wide strip taken from the patient's own thigh mucles; this is harvested above the patella along with an adjacent bone segment.

This portion of the quadriceps tendon is then inserted in the knee joint arthroscopically (i.e. with video camera monitoring). The tendon is fixed with two bioabsorbable screws which dissolve after several months.

The operation is usually carried out under regional anesthesia (no sensation in the legs) and takes about 50 to 60 minutes. The patient spends about three to five days in the hospital. Outpatient physiotherapy is necessary after discharge; this follows a certain protocol. After about two weeks, the patient's full weight can be placed on the knee again. The patient does not have to wear a splint after the operation; starting in the fourth week after the operation, he or she can participate again in certain sports (e.g. swimming, cycling, weight-lifting).

More informations in German:

Das vordere Kreuzband (PDF)
LIVE Operation: Vorderer Kreuzbandersatz mit Quadricepssehne unter Verwendung von bioabsorbierbaren CrossPins (RigidFix®) (Video)