How to break up scar tissue in knee?

How to break up scar tissue in knee

How to break up scar tissue in knee?

01 Understanding scar tissue

When a muscle or ligament is torn or damaged, it is natural for people to think that the body will grow a new muscle or ligament to replace the original injured part. But this is not the case. Muscle and ligament tears or other injuries are repaired by scar tissue.

How to break up scar tissue in knee? Scar tissue is composed of collagen, which is a very fragile and rigid fibrous tissue. Through this fibrous tissue, the injured soft tissues on both sides can be connected together to achieve the purpose of repair. It sounds like scar tissue plays a positive and critical role in injury repair, but it also hinders injury recovery and physical function when mistakes occur:

1. When the damaged tissue area is large and the amount of bleeding is large, a large fibrous scar tissue will be formed. At this time, the scar tissue is large and piled up, which will squeeze other surrounding tissues, and will also fill the gaps or cavities between the tissues, hindering normal limb activities. In some instances, we can see or touch such scar tissue under the skin.

2. When the damage penetrates through different tissues and is relatively deep, adhesions of scar tissues between different tissues will be formed. If no treatment is done at the early stage of adhesion formation, or due to improper training repeatedly causing bleeding, wound tears, scar tissues continue to grow, and adhesions become firm, different tissues will become one when they move, causing limited joint movement and movement Sometimes pain.

02 Understand the reconstruction of the fork

How to break up scar tissue in knee? For knee anterior fork rupture, the current mainstream surgical treatment is arthroscopic intra-knee reconstruction. Compared with open surgery, arthroscopy is a minimally invasive surgery, with a small incision, low risk of infection, and good postoperative recovery.

The main purpose of the operation is to reconstruct a new anterior cruciate ligament to restore its function of maintaining forward stability. Perform diagnostic arthroscopy before surgery to check for intra-articular tissue diseases such as meniscus or cartilage, and deal with it if necessary. Choose a suitable graft for reconstruction and give proper fixation. The bone-patella tendon-bone autograft has bones at both ends and heals well after fixation. The autologous graft is taken from the semitendinosus and gracilis tendon and folded in half to form a quadricus tendon graft. The surgical wound is small. In addition, quadriceps tendon or allograft tendon can also be used as a graft for reconstruction. The two ends of the graft can be fixed with cleansing squeeze screws, internal buttons, and absorbable squeeze screws.

How to break up scar tissue in knee? Then there are two aspects to the rehabilitation after reconstruction:

1. Reconstruct the training and rehabilitation of the anterior cruciate ligament and restore its unique functions;

2. Recovery of surgical damage, to avoid scar tissue affecting joint function;

For people who have undergone sports injuries or have experience in injury rehabilitation, we know that R.I.C.E.R. therapy can be implemented immediately after sports injuries occur, which can limit the formation of scar tissue. R.I.C.E.R. It includes rest, ice compress, compression bandaging, raising the affected limb, treatment plan (this deployment will be very long, put it here first).

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03 Evaluation of postoperative rehabilitation adhesions and scars

1. What is the manifestation of joint adhesion after anterior cruciate ligament reconstruction? How to judge that joint adhesion has occurred? Accurate and effective ACL reconstruction surgery is the basis for normal joint movement after surgery. Therefore, the limitation of joint movement caused by the defects of the operation itself is not within the scope of this discussion.

2. The performance of joint adhesion is easy to understand, manifested as limited movement of joint flexion and extension, and a sense of stiffness in joint movement. Generally, the knee must be fully extended after ACL surgery. The angle of complete extension of the knee joint is defined as 0°, and the normal knee joint has 5-10° hyperextension. Any time after surgery, if there is a restriction of straightening, it can be considered that there is joint adhesion. On the other hand, joint flexion, in order to protect the graft, the knee flexion angle is generally controlled at 90° within 4 weeks after the operation, and the joint flexion angle is gradually increased after 4 weeks, and the joint flexion angle is not less than 120° after 12 weeks.

3. Therefore, if the joint flexion angle is less than 90° at 4 weeks after surgery and less than 120° at 3 months after surgery, it also indicates that the joint has adhesions.

2. How to break up scar tissue in knee? How to classify and define the severity of joint adhesion that occurred in 3 months after the operation? Joint adhesions are divided into 4 types:

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Type 1: Normal flexion, limited straightening <10°

 

Type 2: Normal flexion, limited extension>10°

 

Type 3: Limited flexion>25°with limited straightening>10°

 

Type 4: Restriction of flexion>30° with limitation of extension>10°, accompanied by low patella

Severity classification: Mild: limited knee extension <5°flexion>110° Moderate: limited knee extension 5°-10°, flexion 90°-110° Severe: limited knee extension>10°, flexion <90 °

The above is a simple qualitative judgment. The determination and severity of scar adhesion will be sorted and shared when there is time.

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