Splint for treating an anterior cruciate ligament tear

introduction

The stability of the knee joint is ensured by multiple tendons and ligament structures guaranteed. Of the anterior cruciate ligament tear is one of the most common Ligament injury in the knee joint. In addition to one Swelling and pain especially instabilities in the knee. There is a risk that the lower leg will slip or dislocate forwards in relation to the thigh. In most of all cases, the restoration of stability takes place through a so-called Cruciate ligament surgery instead of. The use of a splint is particularly important in post-operative treatment, although this is also true in the preoperative area (before the operation) a splint can be created.

Definition / description

A Cruciate ligament splint or knee orthosis does the knee joint to calm down. This is done using metal rods that are attached to the thigh (Femur) over the knee joint (Articulatio genus) reach out to the lower leg. These metal bars are in a kind Velcro fastening system introduced, with which the splint on the thigh and lower leg can be attached according to the thickness of the patient's legs so that the splint is stable and does not slip off, but also does not cut into the patient's leg.

The advantage of many of the rails is that they are variably adjustable in angle are. This means the angle at which the thigh and lower leg are held to each other. On each side of the knee there is a wheel or similar mechanism with which a fixed angle can be set or the maximum possible degree of flexion.

Reason for use

A splint for a cruciate ligament rupture can also be used before an operation (preoperatively) be used. If there is an injury where a enormous instability in the knee joint which could result in further complications, putting a splint on the knee joint may be indicated before the operation. Another reason can be simply the Pain problem of the patient which can be improved by immobilizing the knee with a splint. It can also be a strong Joint swelling in the knee the use of a splint as this can accelerate the swelling of the knee.

The use of a splint is of central importance in the post-operative area, i.e. in the follow-up treatment of a knee operation. If, for example, a Cruciate ligament surgery is carried out, the splint is relevant to prevent the plastic from tearing out. During this procedure, a less relevant muscle tendon than Cruciate ligament replacement used and attached in the bone within the knee joint. The anterior cruciate ligament prevents the lower leg from slipping (luxated). It will be at the inflection (Flexion) of the knee stretched. After the operation, the stretching and pulling of the attachment points in the bone should be prevented at all costs, otherwise there would be a risk of the bone tearing out. The same applies to other band structures in a different direction of movement.

Please also read our topic on this Cruciate ligament rupture surgery

Appointment with a knee specialist?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
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The knee joint is one of the joints with the greatest stress.

Therefore, the treatment of the knee joint (e.g. meniscus tear, cartilage damage, cruciate ligament damage, runner's knee, etc.) requires a lot of experience.
I treat a wide variety of knee diseases in a conservative way.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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Use after surgery

As described in the previous sections, the rail set an angle become. The settings below relate to the situation after an operation on the anterior cruciate ligament. The set angle then determines the maximum possible flexion angle. Depending on the attending physician and the type and course of the operations, there is a postoperative Fixation of the knee in a 0 ° - 10 ° extension position instead of. This means that the knee joint can flex a maximum of 10 ° when the splint is on. The splint should be if possible the be worn all day. Furthermore should Crutches used and a Full load avoided become.

Within the next few days there will be an exercise of the knee by one Physiotherapists instead of. This may and should be Flexion of the knee joint carry out. The maximum passive flexion of the knee joint should be slowly increased. On the first postoperative day after pulling the Redon drainage (Tubing in the joint that allows residual blood and fluid to drain from the joint) with a careful passive movement of the knee to be started. It may well be that this is not always completely painless. It is important here that the patient does not actively perform the movements, but that the knee is moved by the therapist (passive movement). In this way, the maximum passive flexion can be increased further and further within the first week. An electronic CPM rail can also be used for this (see below).

From the second week after the operation, the splint can be adjusted to a flexion of up to 90 ° - this means that the patient can bend the knee up to 90 ° with the splint on. Furthermore should Crutches used and loaded with a maximum of 50% of the weight.

From 4th to 5th Week the splint can be used without the maximum flexion setting. The patient can now fully load the joint.

The splint can be removed after about 8 weeks.

The individual times from when and how loads may be used, as well as which maximum angle is allowed, can be different for each person. Accordingly, the patient should contact the Follow-up treatment plan that will be given on discharge from the clinic. Furthermore, this plan should also be applied in relation to the individual healing process. Since there is also a physiotherapeutic follow-up treatment, the further use of the splint is often monitored and controlled by the physiotherapist. In the event of complaints and ambiguities, however, you should definitely see the treating doctor again.

Read our topic for more information Cruciate ligament tear follow-up treatment

Use of the splint in everyday life

Even if the splint on the knee can be annoying, it should definitely be worn, as adequate healing depends on it.

In the The splint should always be worn for the first four weeks become. That also means at night while sleeping. Since unconscious movements or the fading out of the knee problem could provoke the surgical site to be torn out. In the next few weeks it is enough if the splint is put on throughout the day.

Sport and activity

While some sports, such as cycling after a month or swimming, can be resumed after two months, sports that involve rapid movement and / or physical contact should only be resumed after 9-12 months.

In general, the splint should be worn during sport and other activities that stress the knee. It can also mean that it must be worn while working. In general, this should always be done in consultation with the treating doctor.

Please also read our topic on this Cruciate ligament tear duration

Driving a car after a cruciate ligament rupture

A very frequently asked question is whether you can drive a car with a splint on your knee. In general, there are no laws that speak against it. But it should in individual cases with the attending physician and also with the insurance company to what extent reasons speak against it. For the healing process, it is absolutely essential that the splint is also worn when driving a car, so that when the leg is pulled away or the like, there is no excessive bending that could potentially be dangerous for healing.

Motor or CPM rail

CPM is the abbreviation for "Continuous Passive Motion". This is a splint that is operated by a small electric motor and that can help the patient to support the healing process through passive movements.

The patient's affected leg is attached to the splint. By switching on the small motor of the rail, a continuous passive flexion and extension of the knee instead, similar to the movement pattern when cycling.

The enormous advantage of this splint is that, depending on the healing process, every relevant range of motion that is to be practiced in the patient can be set. As a result, the knee can be moved much more frequently without the need for a physiotherapist to be constantly present and without the risk of the patient making excessive movements that would delay the healing process due to a lack of supervision.