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Treatment of Anterior Cruciate Ligament Injury in Germany | ️Best Hospitals, Doctors, Prices | Booking Health™

Anterior Cruciate Ligament Injury. Treatment in Germany

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Best hospitals and doctors for anterior cruciate ligament injury treatment in Germany

Leading hospitals

Cost for treatment

Anterior cruciate ligament (ACL) Injury diagnosis
1294
Arthroscopic or open reconstruction and autotransplantation of anterior cruciate ligament (ACL) injury
6828.8
Arthroscopy to treat anterior cruciate ligament (ACL) injury
6923.6
Orthopedic rehabilitation
690.57
DRK Hospital Berlin Westend
Germany, Berlin
DRK Hospital Berlin Westend
Overall rating10 / 10
The DRK Hospital Berlin Westend is a modern medical facility with a rich historical heritage. It is an academic hospital of the Charite University Hospital Berlin, one of the most prestigious medical facilities in Europe and worldwide. The medical complex is part of the DRK Kliniken Berlin Group, which has a history spanning mor
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Hospital Neuwerk Moenchengladbach
Germany, Moenchengladbach
Hospital Neuwerk Moenchengladbach
Overall rating9.2 / 10
The Hospital Neuwerk, which is in Moenchengladbach, has over 10 specialized operating departments. Located in the northern part of the city, the hospital has been a coordination center for the region for many years. The hospital has 310 comfortable beds for ist patients. Due to a wide range of medical services, the hospital offe
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Catholic Clinic Koblenz-Montabaur
Germany, Koblenz
Catholic Clinic Koblenz-Montabaur
Overall rating10 / 10
The Catholic Clinic Koblenz-Montabaur is a modern medical facility with an excellent reputation in Germany and abroad. The medical center is an academic clinic of the University Hospital Mainz, which gives patients the opportunity to take advantage of scientific advances and innovative treatments. The clinic has the widest possi
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Brothers of Mercy Hospital Munich
Germany, Munich
Brothers of Mercy Hospital Munich
Overall rating10 / 10
According to the Focus magazine, the Brothers of Mercy Hospital Munich ranks among the top German hospitals in the Federal State of Bavaria! The hospital is a modern medical facility with the highest level of medical care and long traditions. The hospital operates on the basis of the Technical University of Munich and the German
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Orthopedic Center Munich East Munich
Germany, Munich
Orthopedic Center Munich East Munich
Overall rating9.8 / 10
The Orthopedic Center Munich East Munich has the status of a leading Orthopedic Clinic in Germany, which meets the high standards of medical care using state-of-the-art medical technologies. The center specializes in the prevention, diagnostics, conservative and surgical treatment of all diseases and injuries of the musculoskele
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Municipal Hospital Karlsruhe
Germany, Karlsruhe
Municipal Hospital Karlsruhe
Overall rating9.8 / 10
The Municipal Hospital Karlsruhe is a modern maximum care medical facility, which combines a long tradition and the advanced achievements of modern medicine. The hospital operates on the basis of the University of Freiburg, so scientific innovations in the field of diagnostics and treatment are continuously introduced into pract
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Vitos Orthopedic Clinic Kassel
Germany, Kassel
Vitos Orthopedic Clinic Kassel
Overall rating9.2 / 10
The Vitos Orthopedic Clinic Kassel is a specialized medical facility where patients can receive top-class diagnostics and conservative and surgical treatment for musculoskeletal diseases, including spinal pathologies. The clinic was founded more than 100 years ago, so it is proud of its rich and successful clinical experience an
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University Hospital Ulm
Germany, Ulm
University Hospital Ulm
Overall rating9.2 / 10
The University Hospital Ulm is an advanced medical complex that provides patients with high-class medical care using the very latest scientific achievements. The medical facility has been performing successful clinical activities for more than 40 years and has long earned an excellent reputation throughout Europe. The hospital r
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University Hospital Heidelberg
Germany, Heidelberg
University Hospital Heidelberg
Overall rating9.8 / 10
According to Focus magazine, the University Hospital Heidelberg ranks among the top five hospitals in Germany! The hospital is one of the most advanced and reputable medical institutions not only in Germany, but throughout Europe. There are more than 43 specialized departments and 13 medical institutes, which cover all fields of
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University Hospital Frankfurt am Main
Germany, Frankfurt am Main
University Hospital Frankfurt am Main
Overall rating10 / 10
According to the reputable Focus magazine, the University Hospital Frankfurt am Main ranks among the top German medical facilities! The hospital was founded in 1914 and today is a well-known German medical facility, which combines rich traditions and scientific innovations. A medical team of more than 6,500 employees cares about
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Charite University Hospital Berlin
Germany, Berlin
Charite University Hospital Berlin
Overall rating9 / 10
According to the authoritative Focus magazine, the Charite University Hospital Berlin occupies the first place in the rating of the top German medical facilities! The hospital is one of the largest and leading university medical complexes in Europe. The hospital in Germany provides modern diagnostics and treatment of patients, a
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University Hospital Rechts der Isar Munich
Germany, Munich
University Hospital Rechts der Isar Munich
Overall rating9.8 / 10
The University Hospital Rechts der Isar Munich was founded in 1834. It combines long traditions with the very latest advances in modern medicine. The medical facility includes 33 specialized departments and 20 interdisciplinary centers, where patients can receive top-class medical care in all medical fields. The hospital annuall
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University Hospital Würzburg
Germany, Würzburg
University Hospital Würzburg
Overall rating9.2 / 10
According to the Focus magazine in 2019, the University Hospital Würzburg ranks among the top national German hospitals! The hospital is one of the oldest medical facilities in Germany. The centuries-old traditions of first-class treatment are combined with the very latest achievements of modern evidence-based medicine and
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University Hospital Carl Gustav Carus Dresden
Germany, Dresden
University Hospital Carl Gustav Carus Dresden
Overall rating9.1 / 10
According to the reputable Focus magazine, the University Hospital Carl Gustav Carus Dresden ranks among the top five German hospitals! The hospital is the benchmark for modern high-quality medicine. Positioning itself as a maximum care medical facility, the hospital represents all medical fields. There are 26 specialized depart
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University Hospital Tuebingen
Germany, Tuebingen
University Hospital Tuebingen
Overall rating9.2 / 10
According to the prestigious medical publication Focus, the University Hospital Tuebingen ranks among the top five German hospitals! The hospital was founded in 1805, therefore it is proud of its long history, unique experience, and outstanding achievements in the field of medical care, as well as research and teaching activitie
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| from Booking Health GmbH

Anterior cruciate ligament (ACL) injury occurs mainly in young people who play sports. The second most common injury cause is the professional training of military personnel. Most often, anterior cruciate ligament injury occurs in men aged 19-25 years. You can undergo treatment for ACL injury in Germany. This country uses minimally invasive arthroscopic surgery. Doctors use modern options for surgical interventions that provide a complete restoration of the biomechanics of the knee, without residual instability, without stiffness, with a minimum rehabilitation period, and a low risk of recurrence of the injury or degenerative changes in the knee. German surgeons have a high reputation, so athletes from all over the world undergo treatment in Germany.

Content

  1. Terms of treatment
  2. Principles of surgical treatment
  3. Materials for ACL plastic repair
  4. Types of surgical interventions
  5. Rehabilitation
  6. Why is it worth undergoing treatment in Germany?

Terms of treatment 

 

To prevent anterior cruciate ligament injury from becoming chronic, it is necessary to perform surgical treatment no later than 3-6 months after the tear. In this case, the damage to the menisci, hyaline cartilage, as well as the capsular and ligamentous apparatus of the knee will be minimal.

The functional viability of the anterior cruciate ligament is very important, because in case it is violated, the biomechanics of the knee joint worsens, and protection from stress effects on the knee decreases. The result is the early development of gonarthrosis: the cartilage in the knee is destroyed, and the person has to implant an artificial joint.

However, with timely treatment, knee function can be fully restored. A person can return to maximum sports loads in a few months. German surgeons provide low-traumatic and reliable treatment, so most patients will not need repeated (revision) ACL surgery in the future.

Principles of surgical treatment 

 

There are two approaches to disease treatment, one of which dominates. The ligament can be repaired or the anterior cruciate ligament can be reconstructed with the autologous, donor, or synthetic materials. In recent years, repair has been extremely rare since only a few injuries are suitable for suturing the patient's ligament. Most patients undergo anterior cruciate ligament reconstruction.

In the case of ACL injury, reconstruction remains the major surgical intervention. Physicians must fully recreate the ACL, providing an anatomical reconstruction for full knee function. To perform it, the orthopedist needs to choose the right sites for the graft attachment and provide the necessary degree of tension in different positions of the joint. With this approach, a person will have no residual knee instability or stiffness after anterior cruciate ligament injury treatment.

In addition, some hospitals perform hybrid surgical interventions. They combine reconstruction with the repair. Such interventions are possible with partial tears. In this case, the doctor creates the new ACL but strengthens it with the fibers of the patient's ligament.

In developed countries, almost all operations for the anterior cruciate ligament injury are performed using a minimally invasive arthroscopic method. Such surgery is performed through short incisions in the knee area. The doctor does not completely open the joint and minimally injures the tissues, creating good conditions for early rehabilitation.

Materials for ACL plastic repair

 

More than 250 surgical treatment methods for anterior cruciate ligament injury have been described. Its reconstruction usually involves the replacement with various materials:

  • autograft; 
  • allograft (donor preserved tendon); 
  • synthetic materials. 

Patellar ligament, semitendinosus tendon, gracilis tendon, or quadriceps tendon are used as the patient's tissues for reconstruction. Each option has its advantages and disadvantages: obtaining material with less trauma, higher strength, better engraftment, lower risk of complications from the donor site, etc. Therefore, in each case, the material for reconstruction is selected individually, depending on the level of the patient's activity, the requirements for a functional, aesthetic result, and the recovery timing after the anterior cruciate ligament injury.

When using the patient's tissues, an additional surgical injury is applied: the doctor has to take a tendon or ligament from the knee or other parts of the lower extremity. Nonetheless, this disadvantage is offset by the fact that the patient receives the strongest, actually native ligament, which, if the operation is performed correctly, will ensure knee stability, the possibility of any loads, and protect against secondary injuries to the cartilage and menisci.

The use of donor grafts does not require an additional incision during surgery, and there is no risk of complications from the donor site, but such tendons are less strong. They are usually implanted in patients with a low level of physical activity: those who do not play sports or do hard physical labor. So the risk of repeated anterior cruciate ligament injury is minimal.

The reconstruction involves the usage of artificial ligaments made of lavsan, polyester, and other materials. They are quite strong, and in recent years new artificial ligaments, such as LARS, have been developed that do not cause reactive synovitis (inflammation of the synovial membrane of the knee due to the presence of foreign tissue in it). To ensure the most physiological result, doctors implant two synthetic tapes. They imitate the anteromedial, and posteromedial ACL bundles.

Types of surgical interventions 

 

The first operations for the anterior cruciate ligament injury treatment were developed in the 20th century. They suggested either suturing the ACL or reconstructing it. The first plastic surgery was performed in 1903 by F. Lange. He used the tendon of the semitendinosus muscle as a material for transplantation, but could not obtain a good functional outcome.

By the middle of the 20th century, there were many options for the surgical treatment of the anterior cruciate ligament injury, and it became more successful. In the second half of the 20th century, they began to use operations that are still being used today.

In 1969, ACL plastic surgery was performed for the first time. It was carried out with the patient's patellar ligament together with a bone block. It provided a secure fixation. The ligament remained attached to the same bone as before, but the bone itself was moved to a different location and implanted with a press-fit fixation.

At the end of the 20th century, double-fascicle ACL plastic surgery appeared. This operation was first performed in 1999. It provided better results than the single-fascicle one and remains the standard of ACL injury treatment today. Physicians implant virtually two new ligaments through two bony tunnels, providing better knee biomechanics with no residual instability.

Today, most ACL reconstruction surgeries are carried out using arthroscopic methods. Doctors no longer open the joint cavity with a large incision. This intervention is traumatic and requires a long recovery. In addition, it has a high risk of complications.

The first arthroscope appeared in the 1970s. In 1976, arthroscopic ACL plastic surgery was performed for the first time. The results were considered good. Arthroscopy continued to evolve, and over several decades, it generally replaced open surgery for ACL injuries.

The main advantages of arthroscopy are as follows: 

  • preserved joint membranes;
  • lack of impaired blood supply and innervation;
  • easier postoperative period;
  • patients recover faster and spend less time in the hospital. 

In the 21st century, hybrid surgery has been developed for ACL injury. If some of the fibers are retained, they are left. With this approach, patients recover faster. Here are some of the benefits of hybrid interventions:

  • they create good conditions for the rapid engraftment of the transplant, so rehabilitation can be started earlier and more intense training can be used; 
  • preservation of the vascular network;

preservation of the mechanoreceptors, that provides the sensitivity of the knee (proprioception).

Rehabilitation 

 

Most people with anterior cruciate ligament injury are young and physically active people. Many go in for sports, including professionally. Therefore, recovering as quickly as possible is one of the treatment goals.

Ligaments grow together for a long time. The whole engraftment occurs within 6 months. Until this time, it is undesirable to maximally load the knee because of the threat of injury recurrence. However, gradually a person restores physical fitness due to limited loads. Already 8 weeks after the surgery, they begin intensive training.

Rehabilitation after the surgical treatment of the ACL injury takes place in four periods: 

  • early postoperative – about 1 week;
  • late postoperative – from 2 to 4 weeks, during which time surgical wounds heal; 
  • functional period – from 5 to 8 weeks, during this time there is a restoration of range of motion in the knee;
  • training and recovery period – patients gradually return to their previous physical form and bring load level to the maximum. 

Although a professional athlete has to recover for up to 6 months. Despite that, a close-to outcome result can be achieved after 4 months. From now on, you can return to sports training, but so far without extreme loads. As early as 4 weeks after the surgery, you can fully rely on the operated leg when walking. From the 6th week, the person does not feel any restrictions on daily activities and considers himself completely healthy.

Doctors in Germany use the latest programs for the patients' rehabilitation after sports injuries. Rehabilitation centers are equipped with state-of-the-art fitness equipment. The optimal mode of training loads is determined individually, based on the results achieved. The patient is regularly examined by specialists to make sure that the loads are safe.

Why is it worth undergoing treatment in Germany?

 

The best treatment for sports knee injuries is in Germany. Here are a few reasons why you should travel to this country to undergo ACL injury treatment:

  • experienced orthopedists with high reputability in the world of sports medicine; 
  • minimally invasive arthroscopic surgery through short incisions;
  • full restoration of the ligament with the patient's tissues or synthetic materials: it will be as strong as before injury;
  • the use of anatomical ACL reconstruction options to ensure optimal knee biomechanics;
  • in patients with partial tears, hybrid operations are performed with the preservation of the fibers of the patient's ACL to speed up recovery;
  • minimal risk of postoperative instability or stiffness;
  • full rehabilitation, providing a quick return to maximum sports loads.

To undergo treatment for the anterior cruciate ligament injury in Germany, you are welcome to use the Booking Health service. On our website, you can get up-to-date and accurate information about the cost of treatment in Germany, compare prices in different German hospitals, and book a medical care program at a favorable price. The treatment will be easier and faster for you, and the cost of treatment in Germany will be lower.

Leave your request on the Booking Health website. Our employee will contact you, consult, and answer all questions. We will take care of the organization of your trip abroad. We will provide the following benefits to you:

  • We will select the best German hospital whose doctors specialize in the treatment for ACL injury in Germany and achieve the best results.
  • We will help overcome the language barrier and establish communication with the doctor from the German hospital.
  • Your waiting time for treatment will be reduced, and you will receive medical care on the most suitable dates.
  • We will reduce the price. The cost of treatment in Germany will be lower than usual due to the lack of overpricing and coefficients for foreign patients.
  • Our specialists will take care of all organizational issues: paperwork, transfer from the airport to the German hospital, and back, hotel booking, and interpreting services.
  • We will prepare your documents and translate them into English or German. You do not have to repeat the previously performed diagnostic procedures.
  • We will keep in touch with the German hospital after the completion of treatment.
  • We will arrange additional diagnostics and treatment if required.
  • We will buy medicines in another country and forward them to your native country.

While the best specialists in the world are taking care of your health, the Booking Health staff will help reduce the cost of treatment in Germany and take care of all the travel arrangements.

 

Authors: 

The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

 

Sources:

Journal of Orthopaedic Trauma

Articles for Orthopaedic Practice - Orthogate

Sience Direct