How to treat patellar ligament injury?

Written by Na Hong Wei
Orthopedics
Updated on September 11, 2024
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First, it is necessary to qualitatively assess the injury of the patellar ligament, determining whether it is a partial or complete rupture, whether it is a simple rupture, or a compound rupture, the latter involving other injuries such as fractures or joint dislocations. The treatment of patellar ligament injuries, like other tendon injuries, follows the principle of "three earlies": early diagnosis, early treatment, and early rehabilitation. Early diagnosis has been mentioned before. Early treatment means that if surgery is needed, it should be conducted as soon as possible, as earlier surgeries often result in better postoperative recoveries. If surgery is not required, an immediate fixation with a cast or brace should be applied to keep the knee joint in an extended position, and this fixation should be maintained for three to four weeks. The third step is early rehabilitation. As the knee joint is immobilized during the fixation period, and pain and swelling starts to decrease, early functional exercises should be initiated, focusing on distal joint movement and muscular isotonic exercises, but avoiding flexion and extension movements of the knee joint. Early rehabilitation primarily aims to prevent muscle atrophy, prevent joint adhesion, and promote recovery from the condition.

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Written by Wang Jing
Pediatric Orthopedics
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Do ligament injuries fear the cold?

Ligament injuries should not naturally be sensitive to cold; however, due to impaired blood circulation in the damaged area or poor blood supply due to scar repair, the circulation in the injured tendons becomes worse compared to other areas. In cold conditions, this can lead to even poorer blood flow. When circulation is poor, it's hard for metabolic byproducts to be removed from the area, leading to their accumulation, which can stimulate the injured site and cause pain. Therefore, areas with ligament injuries often become sensitive to cold, as the cold causes blood vessels to constrict, leading to the accumulation of metabolic by-products and resulting in pain at the affected site.

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Written by Wang Jing
Pediatric Orthopedics
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How to operate on ligament damage

Ligament injuries that affect joint stability require surgery, and different locations necessitate different surgical methods. Generally, for ligaments within a joint, such as the anterior cruciate ligament or the posterior cruciate ligament of the knee, reconstruction is performed using either autografts, allografts, or synthetic tendons to replace the original damaged ligaments. For ligaments outside of a joint, such as the medial collateral ligament, lateral collateral ligament of the knee, or the anterior talofibular ligament of the ankle, if the joint stability is compromised, suturing is generally performed during the acute phase. For chronic, long-standing injuries that affect joint stability, reconstruction is usually necessary, also using autografts, allografts, or synthetic tendons to substitute their function.

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Written by Cheng Bin
Orthopedics
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How to recover from ligament damage

For patients with ligament injuries, it is first necessary to determine the severity of the ligament damage in order to establish an active treatment plan to promote rapid repair of the ligament. If the ligament injury is relatively mild and joint stability is good, it is entirely possible for such patients to choose active conservative treatment. It is necessary to strictly use plaster casts or supportive external fixation. During this period, treatment can include oral non-steroidal anti-inflammatory and pain-relieving medication as well as drugs that promote blood circulation and disperse blood stasis. For those with more severe ligament injuries and poor joint stability, it becomes necessary to actively proceed with surgical treatment, which might involve repairing or reconstructing the damaged ligament. (Please use medication under the guidance of a doctor.)

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Written by Wang Jing
Pediatric Orthopedics
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Is it necessary to get an MRI for a ligament injury?

After ligament injuries, the common imaging examinations usually include standard X-rays, CT scans, and MRI. X-rays are mainly used to observe the overall shape of the bones and the alignment, CT scans are primarily for examining the condition of the bones at the injury site, especially the form of the bones, while MRI mainly uses the hydrogen atom content, or water content, to determine if there is an injury. When a ligament is injured, there won't be bleeding, which leads to an increase in water content; thus, an MRI can easily reveal the increased water content and help diagnose the injury. Therefore, the best method to diagnose ligament injuries is through MRI. Of course, X-rays are used for general overview and alignment, which are the most basic and common examinations, followed by CT scans. Generally, CT scans are not necessary unless there is a special circumstance.

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Written by Na Hong Wei
Orthopedics
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What should I do if the patellar ligament is injured?

Once a patellar ligament injury occurs, the first step is to immobilize the area; stop all activities to prevent further damage and secondary injuries. Secondly, apply ice. The initial ice application should last from half an hour to an hour, applied directly to the injured patellar ligament. Thirdly, bandage to immobilize the area, primarily using an elastic bandage and cotton padding to compress the knee joint. This can help stop bleeding and limit swelling. Fourth, elevate the injured limb to at least 30 degrees above the level of the heart. After these measures, it's necessary to go to the hospital for further examination including physical assessments by a doctor, X-rays, or an MRI to fully understand the extent of the ligament damage. If there is a partial tear of the ligament without complete discontinuity, conservative treatment such as casting or bracing can be effective, typically for three to four weeks. However, if the ligament is completely torn and surgery is clearly indicated, surgical treatment should be followed by the use of a brace for six weeks. Thus, proper early management of a patellar ligament injury is crucial, followed by hospital evaluation. Additionally, since patellar ligament injuries often coincide with fractures or damage to other structures such as the meniscus or cruciate ligaments, these factors cannot be overlooked.