After cruciate ligament reconstruction surgery, many friends are concerned about the healing process between the reconstructed ligament and bone. It is also important for doctors to understand the healing process of key bone in more detail because it is also to guide patients in rehabilitation training. However, due to the particularity of the operation, it isn’t easy to directly study the human body. At present, we can only study this process through animal models.
How does the reconstructed cruciate ligament change in the joint cavity?
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Basic research has found that the healing of the intra-articular part of the graft will go through four stages: ischemic necrosis, vascular reconstruction, cell proliferation, and plasticity maturation. You feel that postoperative recovery is not easy, and its growth and success are full of twists and turns, and it has endured hardships. Histological findings
Two weeks after the operation, the main manifestations were obvious tissue necrosis: the leg tissue necrosis in the bone canal appeared to disappear; the bone marrow cavity was opened, and a large amount of new bone was formed; the granulation tissue interface was formed between the tendon and bone, which was rich in blood vessels, macrophages, and cells. Fibroblasts, disordered arrangement of fibrous tissue (new arrival, unhappy neighbors, lack of food and clothing)
One month after the operation, new tissue was growing from the periphery to replace it. 4-8 weeks rich in cells, but the collagen fibers are arranged disorderly: the necrotic tendon tissue in the bone tunnel has been replaced by new cells from the bone; the granulation-like interface tissue between the tendon and bone disappears, and chondrocytes appear, and the Sharpey fibers follow the direction of stress Connected to bone tissue by chondrocytes, tendons, and bones form connections similar to indirect insertions (self-reliant, somewhat gained, but still focused bad head)
Two months after the operation, the Sharpey fiber connection between the tendon and bone became more Coarse and dense; the indirect stop structure is more mature. At 4 months after the operation, the number of cells decreased, and the collagen fibers longitudinally. Regular arrangement: between tendon and bone calcified tissue and non-calcified group.
A dividing line similar to the tide line has been formed in the weaving room (many businesses have just been smoothed out) 6 months after surgery. Histological appearance similar to a normal fork: tendon
A four-layer structure with direct insertion is formed between bones, followed by Dimensional fibrous tissue, fibrocartilage, calcified cartilage, and bone tissue. The structure of the tidal line between the vitreous and calcified cartilage is still partially clear.
Twelve months after the operation, it was closer to normal: a typical four-layer structure of the direct insertion point was formed, and the tide line was clear, which was very similar to the structure of the normal upper insertion point of the anterior cruciate ligament. (It’s finally Christmas Eve, and it’s still a simple decoration, not a hard decoration).
In addition, small blood vessels originate from the infrapatellar fat pad and joint synovium.
Although revascularization (re-establishment of supply channels) of the graft is possible, revascularization usually takes a long time. thus
It can be seen that it takes at least 6 months for the histological morphology of ACL grafts to be close to normal, and it takes at least one year to recover to almost the same level. ACL surgery recovery time
Although everyone is different, here is an approximate timeline for recovery from ACL surgery that you can expect:
Two weeks after surgery, during the recovery process, is critical because it is when your body is most vulnerable. Surgical pair trauma to your muscles, ligaments, and other tissues experience, which is why the body has an inflammatory response. After surgery, you will experience Pain, swelling, and possibly even a buildup around the knee joint, remaining liquid. The recovery process begins after surgery, and you must not.
Don’t support your recovery with more exercise. You may not be able to bear weight on the affected leg during this time, so plan to use crutches and a brace to help support and protect your leg. 2 to 6 weeks after surgery, you will start to be able to bear weight on your legs. However, the movement is still limited because Your organization is healing itself. The knee is still fragile; you may need a protective brace to protect it from unnecessary stress.
Six weeks to 3 months after surgery, as the treatment progresses and your knee strengthens, you can do lower-impact activities such as cycling and swimming. 3 to 6 months after surgery, during this time, your body. It is ready for a safe return to sports.
After six months, assuming your tissues have fully healed, you can gradually return to exercise. Many doctors recommend using a knee brace for the first year after ACL surgery.