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anterior ligament repair crosses: the patellar ligament, arthroscopy, technical KJ (Kenneth - Jones)

The principle of operation is to repair the anterior cruciate ligament (ACL) with a broken bone autograft bone tendon taken from the patellar tendon.

Intervention performed under local or general anesthesia with a tourniquet to the limb.



1 .Pr├ęl├Ęvement graft:

is removed the central 1/3 of the patellar tendon with a bone rod at each end. The incision is 5 to 8 cm on the front of the knee.



2. Preparation and calibration of graft

It is necessary that the graft is about 10 cm long and 9 to 10 mm in diameter



3. Drilling tunnels under arthroscopic control

the diameter of the bone tunnels is 9 to 10 mm to allow passage of the graft to the tibia and femur. The operation is performed entirely arthroscopically.

4 Positioning of the graft,

Positioning of the graft, arthroscopic control, with fixation of the graft by two resorbable screws or metal (titanium).


5. Control arthroscopic

5. under arthroscopic control the correct positioning of the graft and the absence of conflict in the notch.

End of procedure

The end of surgery, a drain Redon (drain drainage) is set up and the scar is closed by an intradermal running suture with absorbable suture.

A sterile bandage is placed and then a splint immobilization.

The post-operative care

Postoperative pain is controlled by regional anesthesia (femoral block), performed by the anesthesiologist and / or analgesic and anti-inflammatory medications.
Rehabilitation is undertaken immediately after the intervention (stand and walk with crutches and splints, muscle toning and mobilization of the patella)

The Redon drain is removed usually on the 2nd postoperative day.

Clinic output is possible in 3/4 th day after explanation by the surgeon and physiotherapist self-rehabilitation exercises to perform at home.

Recovery work full extension, soft mobilization in flexion and muscle toning the muscles of the thigh.

The trips are with the splint in place, knee extended and crutches.
An order of analgesics and anti-inflammatory medication prescribed by the surgeon.

The dressing should be left in place or strengthened to ablation son.

Rehabilitation:

Rehabilitation is undertaken by a physiotherapist after leaving the clinic at the rate to be modulated according to evolution, from 3 to 5 therapy sessions a week. (City or rehabilitation center)

Recovery:

Stopping the splint and crutches to the 4th postoperative week after active-controlled locking of the quadriceps.

Normal operation and resumption of professional activity possible from the 6 / 8th postoperative week to modulate depending on the occupation (later taken to a labor force)

The resumption of the sport:

Swimming (front crawl, back) from the 2nd postoperative month
Cycling from the 2nd postoperative month
light jogging with gradual increased efforts online, from the 4th postoperative month (flat)
Resumption of training pivot in sports, from 6erne months postoperatively
gradual recovery of the competition from the 8th postoperative month

This sports recovery plan represents a natural evolution in the majority of cases.
Recovery objectives are benchmarks to modulate depending on the evolution of each case.

Doctor Nicolas LEFEVRE, Doctor Serge HERMAN, Doctor Yoann BOHU. - 3 janvier 2015.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.

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