Like a flexed paper clip - long-term damage in non-operated cruciate ligament tear
Currently attracts a study from Sweden by orthopedic professionals, the importance for the patient is not misleading in its turn could. In the study of the cruciate ligament, different therapies are compared - with the result that physically active patients, immediate surgical intervention is not more effective than conservative surgery rehabilitation with only ten weeks after tear of the cruciate ligament. And the record that 60% of all cruciate ligament surgery could be avoided. "This contradicts my 20 years of experience as an orthopedic surgeon," said Dr. Peter Baum, head of the joint-Clinic in Gundelfingen.
Study participants were 18-35 years with no further damage, they were two years after treatment of the cruciate ligament was observed. Divided into three groups - only rehabilitation, rehabilitation after cruciate ligament reconstruction and immediate rehabilitation after delayed surgery - made the equivalent data on 121 patients pain, knee function and general quality of life.
"In reading these results I would also urge a patient to conservative treatment," said Baum understanding. But the warning before an operation he considers fatal conclusion. "Of course, in almost all orthopedic diagnoses first conservative treatment with the patient under discussion. But in the case of an ACL tear are especially long-term results - not just the two years of study - the decisive point." Clinical and experimental studies show that there is no spontaneous healing of the ligaments. A rupture causes instability, which leads to a significant long-term wear and damage the knee sustained damage - until the arthritis.
The post of the joint
Anterior and posterior cruciate ligament in the knee are the central pillars of the joint and its main stabilizers. The extremely heavy-duty belt is under a constant voltage and protects the joint, before the jump muscles. If a defective tape lacks this protective mechanism. Similar is the frequent bending a paper clip to it by stress fractures of the tissue to smallest, degenerative cracks, especially in the meniscus and the cartilage surface. Since this is completely without pain receptors, the symptoms are evident until years later when the defect formation up to the very sensitive enough under the bone lying cartilage layer. Another major factor is the joint destructive entrapment of the torn ligament stumps in the joint and the joint space, which is also a long time may pass unnoticed.
Takes into account the investigation, only the course within the first two years after surgery, "notes tree critical." Because of the too short follow-up period, damage to the menisci are cartilage behind the kneecap and the side bands, as usually after 5 - emerge 10 years do not capture. The study also included patients with no collateral damage to the cartilage or meniscus, but applies only to isolated cruciate ligament injury, which is found relatively infrequently. "
One of the most common sports injuries
The injury of the anterior cruciate ligament is a very common sports injury. In flexion rotation movements such as playing football or skiing in particular at low speed, there is a lever mechanism of the muscles can no longer be kept, so that the strap breaks. A torn ligament is often combined with external or internal meniscus tears or ligament tears of the knee.
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For further information - or images - is available to you:
Dr. Peter Baum
Practice and joint-Clinic
Phone 0171-2747017
E-mail:
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Alte Bundesstraße 29
D-79194 Gundelfingen
The study can be found at: Frobell RB, Roos EM et al: A randomized trail of treatment for acute anterior cruciate ligament tears, New England Journal of Medicine 363, 2010, 331-342
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