The anterior cruciate ligament (ACL) is one of the four major knee ligaments present in the body. This part of knee joint controls the forward and backward movement of the knee. It provides stability to the knee joint. Although the ligaments are very strong but sometimes they suffer mild or severe injuries. A ligament tear may be partial or complete. In partial tearing, only some of the fibers of the ligament are affected. The complete ligament tear involves injury to the whole ligament. Most of the knee ligament injuries are sprains and strains. They recover in a fast manner.
Studies give evidence that females are more commonly injured in ACL than males. The reason includes less physical strength and neuromuscular control. Several other causes are also included:
- Rapid change in direction
- Fall from a height
- Injury from sports or fitness activities
- Hard collision or hit on knee
A crunching or popping sound may be heard when the ACL is injured. Other symptoms include:
- Loss in movement
- Severe swelling, bruising and pain
- Tenderness around the knee joint
- Unstable knee
A thorough examination of the body after ACL injury helps to analyze the severity of the injury. Certain tests such as MRI scan or ultrasound scan gives a clear view of torn ligaments. In mild or moderate knee condition, non-surgical treatment is opted. Surgery is chosen only in severe cases, where non-conservative methods fail.
- Non-surgical Treatments:
Knee instability is common during anterior cruciate ligament (ACL) injury. Braces are recommended to provide the lost stability of knee. In severe cases, to avoid weight on the legs, crutches are also used.
- Physical Therapy
A rehabilitation program is helpful the restore the functionality of the knee. Such program involves specific exercises, which strengthens the muscles of leg. This program is usually initiated after the swelling decreases.
- Surgical Treatments:
ACL reconstruction is the common arthroscopic based surgical method used for treating an ACL injury. Stitching the ACL injury to its original shape is usually unsuccessful. Reconstructing the damaged ligament is the best option to restore the knee stability. The reconstruction procedure makes use of grafts. Several sources such as hamstring tendons, quadriceps tendons, or patellar tendon, can be used to obtain grafts. A tissue graft is used to replace the torn ligament.
During surgery, tiny incisions are created around the knee. An arthroscope along with specialized instruments is inserted through the incision. These instruments are helpful to fix the tendon in exact position. Screws or staples are used for fixation. With time, this mew ligament grows over the tendon.
After the surgery is over, the person is shifted to a recovery room to recover from the effect of anesthesia. The patient may leave the hospital on the same day of surgery. The wound is kept dry and clean for first few days. Light or soft food along with proper medications are beneficial. To regain the pre-surgery strength, a 6 months rehabilitation program is essential. Te early program aims to relieve the swelling and pain in the knee. The result of initial program usually appears within 3-4 weeks. Afterwards, simple exercises such as riding stationary bikes, mini wall sits, etc are done to retain the flexibility and balance of the affected region. Muscle strengthening and full range of motion are achieved during last few weeks of rehabilitation program. The sports person should be away for at least 6 months from their field.
Several risks are associated with the surgical treatment of ACL tear:
- Numbness, blood clots and bleeding
- Pain in kneecap
- Knee Instability and stiffness
- Viral transmission and infection
- Injury to growth plate
- Failed extensor mechanism