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| What
Is The ACL? |
ACL
stands for Anterior Cruciate Ligament of the knee. The knee
is the largest and most complex joint in your body. It depends
on four ligaments and other muscles and tendons to function
properly. There are two ligaments on the sides of the knee:
The Medical Collateral Ligament (MCL) and the Lateral Collateral
Ligament (LCL), and two crossed ligaments in the center
of the knee, the Anterior Cruciate Ligament (ACL) and the
Posterior Cruciate Ligament (PCL)
The ACL connects the front of the shin bone to the back
part of the thigh bone and keeps the shin bone from sliding
forward. |
| What
Is The ACL? |
One
of the common ways for the ACL to be injured is by a direct
blow to the knee, which commonly happens in football or
a fall when skiing. In this case, the knee is forced into
an abnormal position that results in the tearing of one
or more knee ligaments.
However, most ACL tears actually happen without contact
between the knee and another object. Such non-contact injuries
happen when the athlete is planting the foot and cutting,
landing on a straight leg, or making an abrupt stop. These
movements are common in basketball, football, volleyball
and soccer. |
| What
Are The Signs Of An ACL Tear? |
| In
many cases, when the ACL is torn, yo will feel the knee
give way with an audible "pop". The injury is
usually associated with a moderate amount of pain and continued
activity is usually not possible. Over the next several
hours, the knee becomes very swollen and walking becomes
difficult. The swelling and pain usually are the worst for
the first two days and then began to subside. |
| How
Is An ACL Tear Diagnosed? |
 ACL
tears usually cause enough discomfort to cause the injured
person to seek medical attention. The physician will examine
the knee, and, in most cases, be able to identify which
ligaments are injured. However, there may also be injuries
to the joint surface that are more difficult to diagnose.
In addition, swelling may sometimes make it difficult to
diagnose a tear. Further evaluation with an MRI or arthroscope
may be necessary to completely evaluate the injury.
The
most frequently asked question after an ACL injury is, will
I need surgery? The answer varies from person to person.
Many factors must be considered by the patient and the physician
when determining the appropriate treatment. These factors
include the activity level and expectations of the patient,
whether there are associated injuries and the amount of
abnormal knee laxity, or looseness.
A young patient, who wants to return to competitive sports
and has a knee that is very unstable on examination, is
more likely to need surgery for a satisfactory outcome than
an older patient, who wants to return to recreational jogging
and has only mild laxity.
If surgery is not indicated, rehabilitation of the knee
begins with exercises to help restore full range of motion.
This is followed by strengthening exercises for the muscles
around the knee. A return to sports with or without a brace
is allowed only after leg strength, balance and coordination
have returned to near normal. |
| How
Are ACL Tears Treated Surgically? |
| Many
different surgical approaches have been tried for the ACL
injured knee. Years of experience have shown that simply
stitching for the ligament together is rarely successful.
Therefore, current techniques involve reconstruction the
ACL by building a new ligament out of tissue harvested from
one of the other tendons around the knee or form the cadaver.
This tissue is passed through drill holes in the high bone
and shin bone, and then anchored in place to create a new
ACL. Over time, the new ACL regains its blood supply and
cells and becomes a living ligament anchored to the bone
on each end. |
| What
Happens After Surgery? |
Rehabilitation
of the knee after ACL reconstruction requires time and hard
work. Time off from work depends on the type of job, with
people who work at desk jobs able to come back in one or
two weeks, and construction workers usually not able to
return to the job for six months. The same is true for athletes,
with returning to golf occurring more rapidly than returning
to football.
The overall success rate for ACL surgery is very good. Many
studies have shown that over 90% of patients are able to
return to sports and workplace activities without symptoms
of knee instability. Although some patients do complain
of stiffness and pain after surgery, these problems have
been minimized by current surgical techniques and aggressive
rehabilitation. |
Back
to Sports Tips
American
Orthopaedic Society
for Sports Medicine
6300 North River Road, Suite 200
Rosemont, Illinois 60018
http://www.sportsmed.org
|
National
Athletic
Trainers Association
2952 Stemmons Freeway
Dallas, Texas 75247
http://www.nata.org |
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