Cruciate ligament rupture: causes, symptoms, first aid * Crossfit

Sports injuries

1K 0 04/20/2019 (last revision: 10/07/2019)

Cruciate ligament (CS) rupture is a knee injury that is common among athletes. One bundle of ligaments (partial rupture) or two bundles (full) can be damaged.

Ligaments are located inside the joint crosswise relative to each other:

Anterior (ACL) - provides rotational stability of the joint and prevents excessive forward displacement of the lower leg. This ligament is subjected to high stress and is often traumatized.
Back (ZKS) - prevents shifting back.

The reasons

This type of injury belongs to the category of sports injuries. KJ ruptures are common among people who are exposed to intense physical exertion in the course of their professional activities.

Damage occurs when:

a strong blow to the knee from behind or in front;
improper landing after jumping from a hill;
a sharp turn of the thigh outward without simultaneous displacement of the lower leg and foot;
downhill skiing.

Due to the anatomical features of the body, trauma is more common among women.

Causes of occurrence	Description
Differences in the rate of contraction of the thigh muscles.	The hip muscles of women contract faster when flexing. As a result, there is a high load on the ACL, which can provoke its rupture.
Thigh strength.	The stability of the knee fixation depends on the strength of the muscular apparatus. Ligaments are weaker in women, therefore, the risk of injury is higher.
The width of the intercondylar notch.	The narrower it is, the more it is prone to damage during rotation of the lower leg with simultaneous extension.
Hormonal background.	With elevated levels of progesterone and estrogen, the ligaments become weaker.
The angle between the thigh and the lower leg.	This indicator depends on the width of the pelvis. The larger the angle, the higher the risk of damage to the compressor.

Symptoms depending on the degree and type

The clinical manifestations of injury depend on the severity of the injury. There is a certain gradation of the severity of the condition with a ruptured knee joint.

Severity	Symptoms
I - micro fractures.	Severe pain, moderate swelling, impaired range of motion, maintaining knee stability.
II - partial tear.	Even minor damage is enough to aggravate the condition. The manifestations are similar to micro-fractures.
III - complete rupture.	A severe form of injury, which is characterized by sharp pain, swelling, complete limitation of knee movements, joint instability. The leg loses its support function.

The clinic of the disease also depends on the time of injury.

Break types	The duration of the injury
Fresh	During the first days after trauma. Symptoms are severe.
Stale	In the period from 3 weeks to 1.5 months. Differs in erased clinical manifestations and slowly fading symptoms.
Old	It occurs not earlier than after 1.5 months. The knee is unstable, its functionality is completely lost.

First aid

The preservation of the functionality of the injured leg in the future depends on the timeliness and literacy of first aid. As initial therapy, the following steps should be taken before the ambulance arrives:

provide the diseased limb with immobility and lay it on a hill;
fix the knee with an elastic bandage or orthosis;
apply cold;
apply pain medications.

Diagnostics

Recognition of pathology and determination of its type and severity is carried out during the examination of the victim.

First of all, a visual examination by a doctor and palpation of the damaged area is carried out. Anamnesis and patient complaints are studied. To determine which ligament has broken, it is possible to perform the "drawer" test.

If, with a bent knee joint, the lower leg moves freely forward, it means that the victim has a ruptured ACL, backward - ZKS. If the damage is stale or old, the test result may be unclear.

The condition of the lateral ligaments is determined during the above test with a straight leg. Patellar instability indicates the development of hemarthrosis.

Treatment

Therapeutic tactics for rupture of the knee joint is reduced to the use of conservative therapy. In the absence of the desired effect of the treatment, the question of surgical intervention is resolved.

The first part of the treatment is aimed at relieving pain and eliminating swelling. It consists in the use of cold compresses, puncture for hemarthrosis and immobilization of the knee joint using an orthosis, splint or plaster cast. Stabilizing the knee prevents the injury from enlarging. After that, the doctor prescribes a weekly course of NSAIDs and analgesics to the patient.

At the second stage of treatment, a month after the injury, the plaster cast or orthosis is removed and the knee is restored to its functionality. After its completion, the doctor assesses the condition of the joint and decides on the need for surgical intervention.

In the absence of the effect of conservative therapy, a surgical operation is performed. It is prescribed after 1.5 months to avoid various complications. Urgent conduct is advisable:

with complex concomitant injury or damage to a bone fragment;
athletes for accelerated recovery and return to professional sports.

A rupture of the knee joint is treated by carrying out reconstructive plastic surgery:

arthroscopic ligament reconstruction;
using autografts;
with stitching of allografts.

Rehabilitation

Recovery after treatment of CS injury is of two types:

postoperative rehabilitation;
measures after conservative treatment.

After surgical intervention, the patient is contraindicated to load the affected leg. Movement is carried out with crutches. A month later, the performance of therapeutic exercises, dynamic and static exercises on simulators under the guidance of an experienced rehabilitation therapist is prescribed.

Manual and underwater massage accelerates the drainage of lymphatic fluid and the restoration of joint mobility.
Physiotherapy procedures are used.
A visit to the pool is recommended.

Recovery after conservative treatment most often does not exceed 2 months. In this case, rehabilitation measures are aimed at eliminating pain, edema and developing motor capabilities and mobility of the knee joint.

Prevention

To avoid damage to the COP, you must take a responsible attitude to your health. Safety precautions should be observed during sports training and during work.

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