Surgical management of acute injury of the ligaments of the knee joint.

Objective loss of stability is the indication for surgical reconstruction of acute knee ligament injuries. The final diagnosis is established under anaesthesia preceding the operation. This examination also determines the incision and approach. All structures of the knee joint are checked, lesions are precisely reconstructed. This is done by fine sutures in the case of interligamentary ruptures, pull-out sutures with cruciate lesions present, and fixation plate reinsertions of avulsions with or without osseous flakes. Menisci torn from their capsular base should be reinserted whenever possible. Lesions of the cartilage call for adequate primary management. Incisions are closed subsequent to suction drainage. The leg is positioned in a splint in elevation. Early functional therapy is indicated.