ACL injury

Injury to the knees is quite common among people who have an active lifestyle or are engaged in high impact sports. The most injury-prone structure in the knee is the anterior cruciate ligament (ACL). It is one of the four ligaments that support the knee, and provide stability during the movement. The kneecap over the joints may protect these ligaments to some extent.

The ACL originates from the shin-bone (tibia) and runs upward to join the femur, the thigh bone. It is the elasticity of the ligament that helps the shin-bone and femur to coordinate action and bring about any movement. You may find it difficult to move around if you have a torn ACL.

Who is at risk for ACL injury?

If you are engaged in activities that involve-

  • Jumping

  • Running

  • Skiing

  • Abrupt stopping while running

  • Landing on knees

You could be a prospective candidate for ACL injury. The twisting of knees and impact on the knees sideways are common causes of ACL injury. These activities may put undue pressure on the ligaments, tearing it apart. Once injured, the ligaments take a long time to heal.

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Even though strange, but the fact is that females are more prone to ACL injuries, more so if they are into sports. The incidence of ACL injury in female athletes is higher as compared to their male counterparts. The reason behind it is not well understood, but the anatomical and physiological factors seem to contribute.

Signs and Symptoms of an ACL injury

If you have injured your ACL, you are likely to have pain and swelling in the knee. The swelling may increase over 6-8hours, which could make the diagnosis difficult. Injured ACL makes a ‘pop’ sound during movement and you could have the strange feeling of the knees ‘giving way’. Straightening the knees could be extremely painful and walking, a tedious task.

These symptoms should drive you to the nearest orthopedic center for confirmation of diagnosis.

Diagnosis of ACL

Diagnosis of ACL injury can be done by certain maneuvers performed by the doctor. For example, the Lachman test and Pivot Shift Maneuver are performed to test the function of ACL.

The doctor may advise X-rays of the knee to rule out any fractures. MRI is also found helpful to rule out other soft tissue injury. In most cases, physical examination and history of injury are adequate for diagnosing a torn ACL, and no further investigations are required.

Managing an injured ACL

Treatment of ACL injury entirely depends upon the individual’s age, lifestyle, and the level of activity. The ACL can be managed either non-surgically, or through surgical interventions.

Non-surgical treatment or rehabilitation

The non-surgical treatment or rehabilitation involves strengthening of the joints and muscles around the knees to compensate for an unstable knee. Modification of activities and change of hobbies, may be needed for best results. Bracing may be needed to keep the knee stable. The individual can walk using crutches to prevent weight-bearing n the affected knee. With this method, the individual can resume his daily activities in a month but has to say good-bye to those activities, which could have deleterious effects on ACL.

Non-surgical methods are suitable for people with low activity levels and older adults.

Surgery

Individuals who are young, active, want to resume the same lifestyle, and intend to return to sports, are ideal candidates for surgery. The surgery is done through an arthroscope, thus, involves less tissue injury, early recovery, and less pain. The surgery involves reconstruction of the ACL followed by physical therapy. A tissue graft is placed inside the knee, and the new ligament grows over the graft

The rehabilitation may take longer time as compared to non-surgical management. It involves restoring motion in the joints with the help of surrounding muscles, and then strengthening the joint to help adapt to the stress in the ligament. The individual can return to normal activities within 6 months, following a gradual training.

Prevention of ACL injuries

People engaged in sports activities should undergo proper physical training to tune-up their muscles to the offending task. Old people should try not to engage in high impact sports.

If you don’t care about your knee, you could be heading for trouble!