Rishabh Pant airlifted to Mumbai for ligament tear surgery; know about the procedure, recovery time

Second Medical Update – Rishabh Pant

More details here 👇👇https://t.co/VI8pWr54B9

— BCCI (@BCCI) January 4, 2023

“He will be admitted to Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute and will be under the direct supervision of Dr Dinshaw Pardiwala, Head – Centre for Sports Medicine, and Director – arthroscopy and shoulder service at the hospital. Rishabh will undergo surgery and subsequent procedures for ligament tears and will continue to be monitored by the BCCI medical team throughout his recovery and rehabilitation. The Board will make every effort to aid and expedite the recovery process of Rishabh and will provide him with all the support he needs during this period,” Jay Shah, honorary secretary, said in a statement.

Notably, Pardiwala, has previously worked with Sachin Tendulkar, Jasprit Bumrah, and Ravindra Jadeja, as well as with other athletes. Also, indianexpress has learnt that given the nature of the injuries, Pant is expected to take “more than four months” to recover and about six months to return to the pitch.

To recall, Pant had suffered multiple injuries when his car had collided with a road divider on the Delhi-Dehradun highway. The 25-year-old, who was going from Delhi to his home in Uttarakhand’s Roorkee, was first taken to a local hospital before being shifted to Dehradun.

What is a ligament tear and how does it happen?

Ligaments are strong bands of tissue that connect one bone to another and help allow movement between bones. But when the ligaments are stretched or strained beyond normal capacity, they tend to tear. There are three grades of ligament injury: grade 1, a mild ligament tear; grade 2, a moderate ligament tear, and grade 3, a complete ligament tear, or a rupture.

“Anterior cruciate ligament(ACL), Posterior Cruciate Ligament (PCL), lateral and medial collateral ligaments (LCL, MCL) are most commonly injured,” said Dr Udit Kapoor, consultant, Metro Hospital, Faridabad.

How is it diagnosed?

-Detailed history: Your doctor needs to know the exact medical history and the extent of the injury.
-Clinical examination: After examining for tenderness, swelling, and decreased range of motion, the further course of treatment is decided.
-X-ray: Soft tissues like the ACL don’t appear on X-rays, but your doctor may want to rule out broken bones.
-MRI: This exam shows both soft tissue and bone; so, such a tear would show up on the scan.

Treatment 

Treatment for ligament tears depends on the severity of the tear. If the tear is mild, like a minor ankle sprain, it can be treated at home by getting ample amount of rest, icing of the area and letting it heal, said Dr Akhilesh Yadav, associate director – orthopaedics and joint replacement, Max Super Speciality Hospital, Vaishali.

Agreed Dr Richa Kulkarni, chief consulting and sports physiotherapist, Dr Richa’s KINESIS Sports Rehab and Physiotherapy Clinic, Pune described the step-by-step process :

Grade -1: Minor or moderate sprain to the ligament is treated conservatively through rest, ice , medication and physiotherapy.
Grade -2: The partial tear of the ligament is also treated conservatively through rest, ice , medication, physiotherapy and rehabilitation.
Grade -3: The complete tear of the ligament is treated invasively where an operative procedure is done for the reconstruction and then followed by aggressive rehabilitation.

Dr Kapoor said that ideal patients for such a surgery are young individuals (<45 years), and those whose work puts pressure on their muscles and joints, like sportspersons.

Ligaments are bands of elastic tissue around your joints (Source: Thinkstock Images)

What happens during surgery

Dr Kapoor elucidated that such a surgery is done by “arthroscopic technique (making two small holes of 1 cm approximately, each side)”. “Usually, a graft is harvested from the body itself and autografted in the joint. Grafts used are mostly semi-tendinosis (which works to extend at the hip and flex at the knee along with two muscles of the posterior compartment of the thigh), and gracillis (long, thin muscle located in the medial compartment of the thigh),” described Dr Kapoor.

What does the rehabilitative process entail?

The goal of any rehabilitation process is to help the patient regain strength and control over the joint, Dr Yadav said. “Like if we take ACL injury, after the patient undergoes surgery, the rehabilitation process will initially focus on increasing the range of motion of the joint and then move on to strengthening the surrounding muscles. The process will help stabilise the knee and strengthen it to regain balance and control over the knee. The process can take six or more months to complete. Different ligament tears require different techniques and rehabilitation processes to heal and function properly,” Dr Yadav told indianexpress.com.

According to Dr Kapoor, starting two weeks post surgery, knee’s range of motion should be up to 90 degrees with an additional support of a knee brace while walking. Closed chain knee range of motion exercises should be continued for 2-6 weeks,” Dr Kapoor mentioned. When the patient is able to have a full range of motion of the knee, brace can be taken off — usually within a period of 6-12 weeks. “Open chain exercises are recommended starting 12-16 weeks apart along with cardio workouts,” said Dr Kapoor.

How long does it take to make a comeback?

“Sports training can be started after 24 weeks from the surgery,” Dr Kapoor added.

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