Anterior cruciate ligament injury

　　The main cause of anterior cruciate ligament injury is sports injury, accounting for more than 70%. When the knee joint is forcibly overextended or forcibly abducted, it can cause anterior cruciate ligament injury. The sports with the highest number of patients are basketball and football, and it is also common in professional athletes engaged in judo, wrestling, and track and field, as well as in the general population who enjoy skiing, badminton, and volleyball. Non-sports injuries, including traffic accidents and accidental injuries in daily life, account for about 27%.

　　Failure to receive timely treatment for an anterior cruciate ligament rupture or recurrent sprains can easily lead to secondary damage to the knee joint.

　　1. Medial and lateral meniscus injury in the knee joint

　　The meniscus is a crescent-shaped fibrocartilage within the knee joint, located between the articular surface formed by the tibia and femur, which increases the contact area between the femoral condyle and the tibial plateau, thereby enhancing the stability of the knee joint. After the anterior cruciate ligament rupture, due to the forward instability of the knee joint, especially recurrent sprains, the meniscus may produce contradictory movements, leading to secondary injury to the meniscus.

　　2. Knee cartilage injury

　　Long-term instability and recurrent sprains can lead to degenerative changes in the patellofemoral cartilage within the knee joint.

　　3. Osteophyte formation and chronic synovitis

　　Some patients may feel a tearing sound in the knee joint during severe trauma, followed by weakness and severe pain in the knee joint, rapid swelling, and blood accumulation within the joint. Subcutaneous ecchymosis around the joint often indicates joint capsule injury and dysfunction. Patients with old injuries may experience atrophy of the quadriceps femoris muscle and a decrease in motor ability.

　　The prevention of this disease should pay attention to the protection of the joints, do not wear high heels, and can wear a knee brace to protect the joints. In addition, attention should be paid not to overfatigue the ankle ligaments, especially when climbing stairs or mountains.

　　The main examination methods for anterior cruciate ligament injuries are as follows:

　　1. Lachman test.The patient lies flat, bends the knee 15°-20°, and places both feet on the bed. The examiner holds the distal end of the patient's femur with one hand and the proximal end of the tibia with the other hand, making opposite forward and backward movements. If there is more than healthy side forward movement, it is positive.

　　2. X-ray examination of the knee.X-ray examination shows a tibial condyle avulsion fracture. During varus and valgus stress tests, it can be seen that one side of the joint space is widened.

　　3. Knee MRI.

　　4. Knee Arthroscopy.

　　Patients with this disease should choose light foods in their diet, such as various soups. Spicy and刺激性 foods as well as fishy foods can exacerbate joint congestion and swelling, and should be avoided. Patients can eat more high-protein foods such as fish, chicken, and duck, and also eat more foods rich in vitamin C, which can promote the healing of the injury.

　　Surgical repair during the acute stage will exacerbate trauma and affect postoperative joint function, so conservative treatment can be performed early.

　　Firstly, Non-Surgical Treatment

　　For simple anterior cruciate ligament rupture or incomplete rupture, the affected knee can be initially immobilized in a flexed 30° position with a cast. Attention should be paid to push the proximal end of the affected tibia backward before the cast is formed, and it should be fixed for 4-6 weeks. Quadriceps muscle training can begin 3 days after the cast is fixed.

　　Secondly, Surgical Treatment

　　1. For patients with tibial and femoral insertion avulsion fractures that cannot be reduced closed, early surgical reduction should be performed.

　　2. For patients with an internal meniscus tear accompanied by knee locking that cannot be resolved, surgical exploration should be performed.