title: [Our approach to the care of chronic instability of the knee joint].
abstract: Chronic instability of the knee joint is a serious problem for the affected patient and the attending physician. Diagnosis must reveal which structures of the soft knee are insufficient. We use as a basis in particular a detailed clinical examination which frequently must be made under short-term general anaesthesia. As to auxiliary examination methods, we recommend X-rays in forced positions, possibly arthroscopy. Defects of the cruciate ligaments can be evaluated well also by means of computed tomography. Operation should be indicated carefully. We consider the extent of the patient's complaints, the ability of dynamic compensation of the instability, the presence of exudates, haematomas, signs of arthritis, locomotor restrictions and, last not least, also the assumed ability of the patient to cooperate in rehabilitation. In surgical treatment of instabilities it is necessary to respect carefully biomechanical principles of the function of the knee joint. In prostheses of the cruciate ligaments we prefer direct reconstruction with an autologous graft to extraarticular operations. It seems that in older patients also reconstruction with synthetic ligaments will be feasible.
authors.forename: V
authors.initials: V
authors.lastname: Pokorný
authors.forename: O
authors.initials: O
authors.lastname: Mach
authors.forename: Z
authors.initials: Z
authors.lastname: Harnach
authors.forename: K
authors.initials: K
authors.lastname: Unger
mesh_terms: D000328:Adult; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000601:surgery*; D007719:Knee Joint / Q000473:pathology / Q000601:surgery; D008297:Male; D008722:Methods
vernacular_title: Nás prístup k osetrování chronických nestabilit kolenního kloubu.