• Dan Kao

ACL Injury Overview




You may have heard of professional athletes suffering from a knee injury called ACL tear, or have known someone to have suffered from a ACL injury. But what is the ACL, how does it get injured, and what are some treatment options?


What is Anterior Cruciate Ligament?


The anterior cruciate ligament (ACL) is one of the knee ligaments that help stabilize the knee joint. The ACL connects thighbone (femur) to shinbone (tibia).


Anatomy of the Anterior Cruciate Ligament



How Does ACL Tear Happen?


The anterior cruciate ligament is the foremost commonly disrupted ligament of the knee. This can occur when athletes stop, slow down, or change directions suddenly while they’re running and while landing incorrectly or flat-footed from a jump. ACL may also be torn when the knee is hyper-extended. Athletes who participate in sports such as soccer, football, tennis, netball, basketball or volleyball, snow skiing, high jumping or who do gymnastics are more likely to twist their knees by mistake which cause ACL Tear.


ACL tear mechanism





What are the signs and symptoms of ACL Tear?


More common signs and symptoms of an ACL Tear include:


1. A loud "pop" or a "popping" sound or sensation within the knee

2. Severe pain and inability to proceed activity and feeling discomfort while walking

3. Rapid swelling

4. Decreased range of motion

5. Instability with weight bearing


Is your sports career is over now, after ACL injury ?

Can you get back in the game?


Short answer is No! Your sports career is not over yet. You not only recover fully but can also come back faster and stronger than ever.


In this modern era of technology and advancement there are lots of different treatment options available which depend on the severity of the ACL tear or injury and you can get completely recover after the treatment and you can run marathon. Many of those breaks, sprains, and tears aren’t the career-enders that athletes fear anymore.


For example the inspiring story of Adrian Peterson: who had a left knee ACL tear in 2011. In 2012, 10 months after his initial injury, he completely exceeded expectations, running for a career-best 2,097 yards whereas averaging 6.0 yards per carry with 12 touchdowns (and a Pro Bowl performance).


Treatment options:


Non surgical options:


Non surgical options are for patients who have sustained mild or minor injury (Grade 1 injury).


First aid- Mild injuries can be treated using the RICE acronym. Rest, Ice, Compression, and Elevation


Medication- Anti-inflammatory (NSAIDs), such as ibuprofen, can help to reduce swelling and pain.


Immobilization- a brace may be recommended to protect the knee from instability, Crutches may also be recommended to prevent you from putting weight on your leg.


Physical therapy and rehabilitation- may be started after swelling has decreased; Specific exercises will restore function to your knee and strengthen the leg muscles that support it.


Surgical options:


Surgical options are required for Grade 2 and 3 injuries, which require ACL reconstruction. Surgery is normally scheduled after the inflammation has resolved.


Performing an ACL reconstruction too early incredibly increases the hazard of arthrofibrosis, or scar tissue forming within the joint, which would risk a loss of knee motion.


ACL reconstruction surgery procedure:


The ligament is reconstructed with a tissue graft, either from a cadaver (allograft) or from one of your own tendons. This graft will act as platform for a new ligament to develop on.


Grafts or new ACL can be created from a number of different tissues on the knee including: the patellar tendon, which runs between the kneecap and the shinbone (which currently remains the gold standard); the quadriceps tendon, which runs from the kneecap into the thigh; or the hamstring tendon at the back of the thigh.


The reconstruction process involves:


1. Preparing new ACL tissue (graft)

2. Then the tunnels are carefully drilled in the bones(femur and tibia) avoiding the growth plates.

3. Next surgeon places the new ACL in tunnels and securely anchors it within the knee.


The new ACL secures the tibia and re-stabilizes the knee.


ACL reconstruction surgery procedure


Photo courtesy of Tower Orthopedics


After the surgery procedure:


You will be monitored in the recovery room until you are more awake and stable. Nearly all ACL cases go home the same day with a knee brace and crutches for 1-4 weeks.


What about ACL complete recovery?


Recovery


Whether your treatment includes surgery or not, physical therapy plays a crucial part in helping you regain knee strength and movement, and getting you back to normal activities. In case you experience surgery, your physical therapy will begin 2-3 days after surgery with focus on returning movement to the joint and surrounding muscles.


Can you jump or run again after your complete recovery?


Yes! With the right recovery and a lot of mental toughness, athletes can return better, faster, and stronger.


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Have more questions about your upcoming knee replacement? Sign up today for your free personalized pre-op consult with a Orthopedic/Spine Nurse Practitioner or Medical Device Specialist today!

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