It combines analgesic (pain-relieving) treatment, relative immobilization and early rehabilitation, depending on the severity of the sprain.
Rehabilitation is possible as soon as the knee is less painful and swollen. It consists in compensating for the absence of the anterior cruciate ligament through muscular and proprioceptive re-education, enabling the knee to remain more or less stable.
Surgical treatment consists of reconstructing the anterior cruciate ligament using a graft. Depending on several parameters, the choice is between the patellar tendon and the crow's-foot tendons (1/2 tendon and medial rectus).
You can live with a ruptured ligament, even if the knee remains somewhat unstable...
But... You need a stable knee for demanding sports or professional activities.
The absence of a cruciate ligament induces false movement in the knee, which over time leads to premature wear of the cartilage (osteoarthritis).
It has been proven that these instability accidents damage the cartilage, and the risk of osteoarthritis becomes significant after 10 to 15 years if the knee remains unstable.
Surgical treatment should be offered to young, active people, but I believe that all cruciate ligament injuries should be treated surgically before the age of 55.
Physical work involving the carrying of loads, or work in construction or on roofs, will prompt us to suggest surgical treatment.
Immobilization with a splint is systematic for 2 weeks. Resumption of walking with full weight-bearing is usually possible the following day.
When you are discharged, the prescription will include :
Rehabilitation begins the day after surgery. (The rehabilitation plan can be downloaded from the website).
For rehabilitation, you can follow a rehabilitation schedule
Contract your thigh muscle (quadriceps). Then press your knee firmly against the bed sheet: hold for a few seconds, then release. If you try often, you'll achieve a result (series of 10 contractions as soon as you wake up from anaesthesia). The following day and for the next 15 days, you'll need to do 20 series of 20 contractions, gradually increasing the duration of the contraction.
Applying an ice pack should be a daily routine, and all the more frequent the more gonflé and/or painful your knee is. For 30 minutes, 4 to 5 times a day, apply an ice bladder filled with ice cubes and water, wrapped in a cloth.
Walk regularly, starting the very next day, gradually increasing your pace. Walk with your knee "locked", i.e. in extension, contracting your quadriceps with the knee protected by a splint. You'll need to keep this splint on when walking for 2 weeks.
On average, work can be resumed between 6 and 12 weeks after the operation, depending on the profession.
Some sports (swimming, cycling) can be resumed after 2-3 months. Other sports involving rotation in the knee (soccer, tennis, skiing) can be resumed from the 7th-9th post-operative month.
Complications are rare (residual pain, hematoma, phlebitis, infection, post-operative stiffness).
In most cases, after consulting you, the surgeon will order a magnetic resonance scan or an arthroscanner. These examinations should confirm any damage to the cruciate ligament, as well as any other associated injuries.
Severe sprains are often accompanied by a cracking sensation at the time of the accident, as well as acute pain and a feeling of dislocation. Once torn, the ligament does not heal. The knee swells, and you're often unable to move or lean on it. Pain is a function of the associated lesions.
Over time, the pain diminishes, and you can walk, but the knee remains unstable, with frequent slipping and dropping. It remains very difficult to play the sports you love (jogging, tennis, skiing, etc.).
A knee sprain is said to be "severe" when it is accompanied by internal damage to the joint. This can include fractures, collateral ligament damage, meniscus damage and, above all, damage to the so-called "central pivot" ligaments, well known to sportsmen and women, i.e. the anterior cruciate ligament and the posterior cruciate ligament.
Injury to the ACL (anterior cruciate ligament) of the knee is often the result of a trauma sustained during sport. The most typical case is the pivoting of the knee with the foot fixed to the ground.