In the 1960s and 70s, there was a change in the management of knee joint ligament injuries. Better understanding of the anatomy and functions of the knee ligament structures as well as of their importance with regard to the biomechanics of the knee has led to a shift from the previous conservative treatment based almost exclusively on the principles of Böhler, towards surgical management. In Hungary, major changes in the treatment of acute ligament injuries began in the early 1970s: it was then that we started to treat surgically the acute, unstable ligament injuries. Back then, however, the bio- and patho-mechanical ideas prevailed that the stability of the knee is established by four major ligaments (the two collateral and the two cruciate ligaments), and that medial or lateral tear of the collateral ligaments causes instability in varus or valgus directions, in the frontal plane, while the tear of the ACL or PCL causes instability in the sagittal plane. As a result, diagnostic methods were limited only to examine instabilities in the respective directions. Nowadays, the operative indication of acute ligament injuries is based on highly differentiated examinations. Not only a significant portion of the acute ligament injuries and bony lacerations are recommended for surgical treatment, but aditionally the complex capsule-ligament injuries that can be a combination of injuries of several ligament structures, the meniscus and the cartilage, and that are usually caused by strong rotational forces of varus or valgus trauma. The advance of surgical treatment has been facilitated by new surgical techniques, delicate, atraumatic suture techniques, and functionally oriented post-operative treatment.
|Translated title of the contribution||The modern approach of the treatment of the anterior cruciate ligament's injury|
|Number of pages||7|
|Publication status||Published - Dec 1 2010|
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