Treatment and rehabilitation principles after multiple knee injuries

  This is a difficult topic because the knee is the most complex joint in the human body and there are many different parts of the body that can be damaged after an injury, and the various rehabilitation plans that can be found in writing are all tailored to a particular injury, with different recovery times for different tissues. However, it is unrealistic to develop the most comprehensive rehabilitation plan, and there is also the problem of how to choose the treatment, so I can’t tell you all the problems, but I can give you some principles and opinions, and when you encounter contradictions, you can make your own judgment according to this principle, and there are also some points that need to be noted.  1, the healing of the ligament tissue needs at least 6 weeks, so the lateral collateral ligament repair generally needs to be fixed for more than 6 weeks, while the ACL reconstruction and partial meniscus removal requires joint flexion and extension training within a week, so this is a contradiction, the principle of dealing with this contradiction is: the braking of the joint should be implemented according to the long time, so for the ACL reconstruction and collateral ligament injury at the same time generally need Braking for about 6 weeks, but during the period can occasionally slowly flexion and extension, because too long braking joints have the risk of stiffness; for meniscus suture is the same reason, meniscus suture after 6 weeks need to brake, so for the ACL reconstruction with collateral ligament repair and/or meniscus suture to brake a little longer, flexion and extension training to be later; 2, more exercise is not necessarily is more exercise; some friends told me, today a breath of practice a few thousand, training very hard a lot, in fact, this practice is not scientific, scientific training is divided into components of training, rather than a breath of exhaustion; some friends told me today walked a lot, should train a lot, this understanding is also problematic, walking does not mean that your effective training, so you can not exercise completely 3, the principle of gradual progress, most people want to step in place, as soon as possible, but we always give our body time to let him recover, so do not rush, as long as the correct method of training, there will always be good results; 4, can not “wait”, this is a feature of our joint injury rehabilitation, may Most of my friends understand, unlike other diseases, waiting for the wound to heal after surgery, and some friends told me, Dr. Song, wait for me to go home and then practice, or wait until I have time to practice, these understandings are not desirable, there are different training methods at different times after surgery, miss a period of training in the future is very difficult to catch up, many people know that muscle atrophy is very difficult to 5, multiple injuries after braking position is different, the principle of choosing these positions is the non-stress position of the injured tissue, so in the choice of postoperative position should try to let the injury of each tissue in a non-stress state; for example, medial collateral ligament injury to let the joint in the inversion position, lateral collateral ligament injury can let the 6, multiple injuries if there is no very special reasons, try to get it done in one operation, of course, there are some professors advocate the lateral collateral ligament injury and ACL reconstruction separately, but I personally think it is best to do it together, the rehabilitation time will be longer than a simple injury, but certainly shorter than two separate rehabilitation time, and do not have to suffer from surgery, economically 7, cruciate ligament injury accompanied by collateral ligament injury, in the selection of grafts, it is best not to play the idea of the affected leg, it is best to choose the allograft or the other foot, so as not to make the joint more unstable.