Operative und konservative Therapie der vorderen Kreuzbandruptur im Sport

Injuries of the cruciate ligaments are frequent in sport and are one of the most frequent causes of sport invalidity. Conservative and surgical treatment options are possible for ruptures of the anterior cruciate ligament. What are the current treatment recommendations? This article examines exactly this question and presents the surgical and conservative therapy options. The anamnesis is given priority in the diagnostics. The following are established tests to investigate the integrity of the anterior cruciate ligament: the Lachman test, the pivot shift test and the anterior drawer test. Whereas accompanying bony injuries can be detected by native X‑ray imaging, magnetic resonance imaging (MRI) is suitable for the diagnostics of cruciate ligament injuries. Although conservative therapy of anterior cruciate ligament lesions can be successful, it has been shown that surgical reconstruction is more often necessary, particularly for highly demanding sporting activities; however, the original knee function can never be restored in an identical fashion by reconstruction of the anterior cruciate ligament. This explains why not all athletes can return to the same performance level achieved before the cruciate ligament lesion and only 55 % can maintain sport at a competition level.