WHAT YOU SHOULD KNOW
If a joint is left unstable without some of its ligaments functioning properly that joint will develop arthritis. The reason is that the two cartilage surfaces do not rub each other correctly when the ligaments that control motion of the joint are deficient. Ligaments are the connections from one bone directly to another bone. Tendons are the connection from a muscle to a bone. Ligaments are about ten times more elastic than tendons.
MEDICAL HISTORY
Patients may complain of pain, sense of instability, weakness, stiffness, and loss of function. All the details of the original injury and subsequent treatments must be reviewed. The patient should bring the typewritten reports of any previous surgeries that have been performed.
EXAMINATION
The joint will be tested for stability and range of motion. The tendons that work the joint will all be tested.
ADDITIONAL TESTS
Plain x-rays are done to see if any early arthritis has already developed and how far out of place the joint is sitting.
TREATMENT OPTIONS
| LIGAMENT RECONSTRUCTION | FUSION | |
| CONSISTS OF | Taking tissue from elsewhere in the body to rebuild the missing ligaments that stabilize the joint | Causing the two bones that make up the joint to heal to each other |
| FEATURES | A tendon from the forearm is the usual source | Internal fixation hardware usually used to hold the bones while they heal |
| ADVANTAGES | Maintains joint motion | Solid, durable |
| DISADVANTAGES | A tendon cannot ever recreate the function of a ligament | No motion |
RECOVERY
The joint may be temporarily pinned in place to protect the healing ligament reconstruction. These are usually removed anywhere from 4-8 weeks later. After initial healing of the new ligament, the joint will be stiff and require outpatient rehabilitation exercises for motion and then strength development. The entire process takes anywhere from 10 to 16 weeks depending on which joint is involved.
