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39 years
I had an operation of ligament croisé since 10 month and still having pain when i go up the stairs what to u think the prob is? thanks in advance
Aug 31, 2014

Dr. Zakia Dimassi Pediatrics
The course of therapy after cruciate ligament surgery may vary somewhat according to the specific type or reconstruction done (particularly if additional meniscus or ligament surgery was done).
Physical therapy is done under the supervision of a specialized therapist. In the initial recovery phase, visits may be 2 to 3 times per week, but later once every week or two will suffice. Exercises at home are done on days not scheduled for a formal therapy session.

The rehabilitation following cruciate ligament reconstruction is based on three main phases. Phase one consists of controlling the pain and swelling in the knee, re-establishing knee motion, and getting early return of muscle strength. The operated leg is typically placed into a hinged brace after surgery.

In the early period after surgery, weight-bearing is allowed with crutches and is gradually advanced to full weight bearing independent of crutches according to how much swelling, motion, and muscle strength allow. Most patients need to be on crutches for one week, but some may require the use of crutches for longer shorter periods of time. This phase typically takes 6 to 8 weeks.

The second phase focuses on continued control of swelling and recovery of full muscle strength. Cycling, treadmill running, and light jogging are begun in this phase. This phase usually lasts from 2 to 4 months after surgery.

The final phase consists of graduated return to full activity. Full motion, normal muscle strength, and the absence of swelling are necessary for successful return to activity. A brace may be recommended early in the return to activity. This phase falls at 4 to 8 months after surgery, depending on the particular patient and the nature of their activities.

Patients should not to attempt to return to full activity too early as this may result in knee inflammation or re-injury. Proper graft healing and incorporation into the knee are a must: too much stress too soon may increase the risk of graft failure.

The majority of patients experience no complications and return to full activity between 6 and 8 months after surgery. However, the most common complications include pain in the front of the knee and loss of knee motion.

Pain in the front of the knee occurs in 10-20% of patients. This is managed usually by modification in the physical therapy protocol. Loss of motion occurs in less than 5% of patients and is most commonly encountered in patients with originally limited motion before surgery. While correctable with more aggressive therapy in most patients, it may necessitate re-operation in rare cases. In some cases, intermittent pain and swelling are associated with activity despite a successful ligament reconstruction. This is often related to the extent of meniscal or cartilage injury that was present and identified at the time of surgery.

A small number of patients will end up with a persistent detectable increased amount of motion in their knee (a "loose" graft). This may be related to stretching of the graft over time, or due to reinjury.

An estimated 95% of patients resume previous level of activity without restrictions. In the remaining 5%, full return may be limited by a number of causes: pain, swelling, persistent laxity, change in lifestyle related to age, intentional choice, or other unidentifiable causes.
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