The anterior cruciate ligament
(ACL) is considered one of the major ligaments in the knee.
Most ACL injuries occur during
sports that entail jumping, drastic direction changes, and sudden stops like
soccer, football, volleyball, gymnastics, tennis, basketball, and downhill
skiing.
Many people often feel or hear a
“pop” in the knee during an ACL injury.
The knee may also swell and feel
unstable.
In addition, bearing weight might
become too painful.
Treatment options recommended will depend on the
injury’s severity.
Depending on the situation, an ACL injury may
require rehabilitation exercises and rest (to regain stability and strength) or
it may require surgery (to replace the ligament that is torn).
Causes
The strong tissue bands that connects one bone
to another are called ligaments.
The ACL is one of the two ligaments in the
knee.
It connects the femur (thigh bone) to the
tibia (shin bone).
It also helps stabilize the knee joint.
·
Drastically changing directions or slowing
down suddenly
·
Pivoting with the foot firmly planted
·
Suddenly stopping
·
Incorrectly landing from a jump
·
During collision or when receiving a direct
knee blow
Damage to the ligament can be partial or
complete.
A mild injury can overextend the ligament but
still leave it intact.
Symptoms
Some of the most prevalent signs of an ACL
injury includes:
·
A “popping” sensation or a loud “pop” in the
knee
·
Inability to continue activity
·
Extreme pain
·
Swelling (often manifests within a few hours)
·
Range of motion loss
·
Feeling of instability
Diagnosis
During the physical examination, the doctor
will move the knee into several positions to gauge the range of motion and the
joint’s overall function.
Signs of tenderness and swelling will also be
checked.
In most cases, diagnosis can be made based on
the physical exam alone.
However, other tests might be recommended to
determine the injury’s severity and rule out other likely causes.
Tests can include:
·
Magnetic resonance imaging (MRI)
·
X-rays
·
Ultrasound
Treatment
Home Care
Prompt first aid care has been known to help
reduce the swelling and minimize the pain after a knee injury.
The R.I.C.E. model is often recommended.
Rest – limiting weight bearing and resting is
considered ideal.
Ice – putting ice on the knee preferably
every 2 hours (for 20 minutes each time) is recommended.
Compression – wrapping a compression wrap or
an elastic bandage around the injured knee is advised.
Elevation – lying down with the affected knee
propped up on some pillow is suggested.
Rehabilitation
Treatment for ACL injuries often commence
with many weeks of rehabilitative therapy.
Exercises at home or with continued
supervision will be taught by a physical therapist.
Wearing a brace (to stabilize the knee) or
using crutches (to avoid weight bearing) might also be prescribed.
The key goals of rehabilitation include
restoration of the knee’s full range, minimizing swelling and pain, and
strengthening the muscles.
Surgery
Surgery might be recommended in the following
scenarios:
·
Patient is an athlete and wants to continue
doing sports that entail cutting, pivoting, and jumping
·
More than one cartilage or ligament in the
knee is injured
·
Patient is active and young
·
The injury causes the knee to buckle up when
doing routine day-to-day activities
During ACL reconstruction, the damaged
ligament is removed and it replaced with a segment of tendon.
The replacement tissue is called a graft.
The surgeon will then use another piece of
tendon (taken from another part of the knee or from a deceased donor).
The graft will function as a scaffolding
where new ligament tissues can grow.
Another course of rehabilitative therapy is
undertaken after surgery.
Rigorous rehabilitation and successful ACL
reconstruction can often restore knee function and stability.
Oftentimes, athletes can already continue to
engage in sports after just 8 to 12 months.
