Surgical treatments
Your doctor may recommend surgical treatment where the level of damage is sufficiently serious to warrant it – for example you have ruptured the ligament or more than one ligament in the joint is damaged. Various methods to repair ruptured ligaments are available, including synthetic ligaments and tissue grafting, where natural tissue is harvested and transplanted to reconstruct or repair the damaged soft tissue. Not all surgeons offer all treatments, so it is important to ask to be referred to a surgeon who offers those you wish to consider.
Grafts
An ‘autograft’ is where a suitable piece of tissue is taken from another area of the patient’s body to reconstruct the damaged ligaments. Grafts are commonly harvested from the patellar tendon/quadriceps tendon attached to the knee cap, or hamstring tendons from the inside of the patient’s thigh. This process though can cause pain and dysfunction at the harvest site, pain when kneeling, reduced strength of the soft tissues from where the graft was harvested; thereby reducing the function of the knee, from around which the grafts were taken, for some years after the surgery is performed.
An ‘allograft’ is a similar concept, but the tissue used to make the repair is donated from another patient. Allografts pose a risk of disease transmission and tissue rejection from the recipient of the graft, however the recipient does not incur further injury to an already compromised knee, where knee ligament repair may be required.
Both of these grafting procedures require the same extended period of healing and re-vascularisation post-surgery, and it is usually around six to eight months before normal sporting activity could be resumed.
Synthetic ligaments
Synthetic ligaments, such as LARS (Ligament Augmentation & Reconstruction System) are specially manufactured artificial grafts for a number of different applications. The type of surgery, patient anatomy or required level of physical activity will dictate which ligament your surgeon deems most suitable for you. Artificial ligaments will be selected to be as strong, and in some cases stronger, than the original native tissue.
In the past, some of the earlier synthetic ligaments were sometimes beset by the problems of stretching, prematurely breaking or causing inflammation. LARS has been specially designed to avoid these issues. The biggest advancement in present-day synthetics is that they encourage in-growth from the surrounding tissues and ligaments, which allows the patient’s damaged ligaments to repair themselves, while supporting the joint and allowing early mobilisation and return of joint function, without the need to remove healthy tissue from the recipient or a donor patient.
Synthetic ligaments can offer many advantages over autografts or allografts:
- Healthy tissue does not have to be removed from the patient’s other ligaments for use as a graft, avoiding the problems that can otherwise sometimes occur around the harvest site.
- Preserves soft tissues in the event that they should need to be used in other procedures.
- No tissue is implanted into the patient from another person, avoiding any potential problems caused by the patient’s body rejecting the donor tissue or possible disease transmission.
- The wide variety of types of synthetic ligaments – the different shapes and sizes – mean that they can be matched ideally to suit the patient’s size and ongoing requirements for the new ligaments (particularly if a high level of physical activity, and hence endurance, is important).
- Surgery time is reduced as there is no harvesting of grafts.
- Reduced muscular wasting as most LARS repairs are performed in the acute injury phase and rehabilitation usually begins within a few days of surgery.
- Can provide a quicker return to a normal lifestyle, and even to sporting activity
Important: The information and guidance provided here is general in nature and should not be considered as medical advice in any way. You should always seek detailed advice from a qualified medical practitioner.
