Orthopedics · Knee
Torn anterior cruciate ligament
Does your knee give way after an injury, and you no longer trust it? The anterior cruciate ligament keeps the knee stable, especially when pivoting. If it is torn and the knee stays unstable, Prof. Hart replaces it during arthroscopy with a graft from your own tendon. If everything is in order, the procedure can take place as soon as within a week of the consultation.
- No referral from a primary care doctor needed
- Surgery by Prof. MUDr. Radek Hart
Arthroscopic ligament reconstruction
- new ligament
- graftfrom your own tendon, arthroscopically through small incisions
- until the procedure
- 1 weekfrom the consultation, if everything is in order
- surgery takes
- 30 min–3 hoursis the usual length of arthroscopic procedures, depending on the extent
- back to sports
- 6–12 monthsusually, depending on knee strength and stability
01When surgery is considered
A knee that gives way
The anterior cruciate ligament runs diagonally through the center of the knee from the thighbone to the shinbone. It prevents the shinbone from slipping forward and keeps the knee stable when pivoting. It most often tears during a sudden change of direction, an abrupt stop or a bad landing after a jump, often without a direct blow to the knee.
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A pop and swelling
At the time of injury you may hear a pop and feel the knee give way. It usually swells within 24 hours. Swelling and pain may subside on their own, but the feeling of instability often remains, and returning to full activity makes it worse.
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The knee gives way
The knee feels loose or buckles. Some people feel it already when walking, others only in sports with pivoting, cutting and landing from jumps. How much depends partly on the strength of the muscles around the knee.
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Damage elsewhere in the knee
In roughly half of injuries the meniscus, cartilage or another ligament is damaged along with the ligament. If the knee stays unstable for a long time, damage to the meniscus and cartilage increases over time.
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A fresh injury goes to urgent care first
The HR Clinic practice is not an emergency room. A fresh knee injury should first be seen at a trauma clinic or emergency department. Come to us afterward for further examination, a treatment plan or a second opinion.
- anterior cruciate ligament
- posterior cruciate ligament
- graft from your own tendon
- knee bones
- site of the tear
02Treatment
Not every torn ligament needs surgery
What matters is how unstable the knee is, what movements you need from it at work and in sports, and whether other parts of the knee are damaged as well. Age does not decide on surgery, but how active you are. The doctor determines the approach with you at the consultation.
Without surgery
Physiotherapy and brace
Always an option, often as a first step.
- Exercises gradually restore thigh muscle strength and confidence in the knee
- A brace can protect the knee during sports
When it is often enough
The knee holds
Lower demands on the knee.
- The ligament is only partly torn and the knee does not give way
- The knee is stable and you do not play sports with pivoting and cutting
- Lighter physical work or a calmer lifestyle
With surgery
Ligament reconstruction
When the knee stays unstable.
- Physiotherapy did not help and the knee keeps giving way
- You want to keep playing sports with pivoting and jumping, or you have physically demanding work
- The meniscus or another part of the knee is damaged along with the ligament
Not sure what is right for your knee? The examination decides. Book a consultation
03How the procedure works
From booking to going home
The reconstruction is done arthroscopically, through small incisions. The doctor first checks the ligament and the other parts of the knee with a camera. Through further small incisions the torn ligament is then replaced with a graft from your own tendon, placed where the original ligament was and anchored in the bone.
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Booking
Online or by phone. A referral from a primary care doctor is not required.
online or by phone -
Consultation and examination
Prof. Hart examines the knee and compares it with the healthy one. An MRI shows how badly the ligament is damaged and whether the meniscus or cartilage was also affected.
diagnosis and treatment plan -
Procedure
Arthroscopic procedures usually take between half an hour and three hours, depending on the extent.
within a week of consultation -
Home and exercises
Exercises start right after the procedure. At first crutches and, if needed, a brace will help you. Do not drive until your doctor allows it; someone must take you home.
checkup and physiotherapy
04Recovery and physiotherapy
Returning to sports takes months
Careful rehabilitation plays a large part in the result of the reconstruction. Regular physiotherapy continues for several months, and if needed we continue it right at the clinic.
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The first 7 to 10 days
Keep the wound dry, use cooling and keep the leg elevated when resting. The goal is to fully straighten the knee again and control the thigh muscle.
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Return to work
It depends on how physically demanding the work is. You will manage most everyday activities within a few months.
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Sports after 6 to 12 months
You return to sports once the knee neither hurts nor swells, can be fully bent and straightened, and the strength, endurance and balance of the leg are back. Progress decides, not the calendar.
05Who operates
Prof. MUDr. Radek Hart, Ph.D., FRCS, MHA
Orthopedic surgeon and trauma specialist of the musculoskeletal system, chief physician of HR Clinic. He reconstructs a torn anterior cruciate ligament arthroscopically with a graft from your own tendon, with the aim of a safe return to sports. He sees patients in Znojmo and in Vienna; after a consultation in Vienna the procedure can be performed in Znojmo.
More about Prof. Hart Professional site ortho-hart.at
Price We will tell you the price of the procedure at the consultation, depending on the findings and the extent of the procedure.
06Common questions
What patients ask most often
Does a torn ligament always need surgery?
No. For a partial tear without instability, or for a stable knee without sports that involve pivoting, physiotherapy is often enough. A completely torn ligament, however, is usually reconstructed because the knee stays unstable. Repeated giving way of the knee also damages the meniscus and cartilage over time.
Am I too old for surgery?
Age does not decide on reconstruction, but how active you are. If you play sports with pivoting and jumping, or have physically demanding work, and the knee gives way, it makes sense to consider surgery even at a higher age.
Why is the ligament replaced rather than sutured?
The anterior cruciate ligament has a poor blood supply and is surrounded by joint fluid, so it heals poorly in the knee and a suture often does not hold. That is why it is usually replaced with a tendon graft. Suturing is an option only for selected types of injury.
Where does the graft come from?
Prof. Hart replaces the ligament with a graft from the patient's own tendon. He will explain at the consultation which tendon he takes the graft from and why.
What are the risks?
Most patients have no complications after reconstruction. As with any surgery, there can be a wound infection or a blood clot. The knee may remain stiff, painful or unstable, there may be problems at the graft harvest site, and the graft may tear again. The doctor will go through the risks with you before the procedure.
When should I contact you right away after the procedure?
If you have throbbing or cramping pain in the leg, fever or chills, pus drains from the wound, or swelling, pain or redness of the knee gets worse. If you have pain and swelling in the leg together with shortness of breath or chest pain, call the emergency number (112, in the Czech Republic also 155).
Do I need a referral from a primary care doctor?
No. Just book online or by phone.
07Booking
Book an orthopedic consultation
Online or by phone, at the clinic in Znojmo. A referral from a primary care doctor is not required.
- +420 515 225 520
- info@webdemo.dam-medizin.com
- Kotkova 3974/9c, 669 02 ZnojmoMon: 8:30–15:00 · Tue–Fri: by appointment
