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What is ACL injury?

femur
femur

A.Anterior Cruciate Ligament (ACL) Injuries What is anterior cruciate ligament injury?

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Anterior cruciate ligament (ACL) injuries are among the most serious knee injuries.

Athletes who engage in high-demand sports such as soccer, American football, and basketball are more prone to ACL injuries.

If you have an ACL injury, you may need surgery. It depends on several factors. For example, it depends on the degree of damage and your level of activity.

One of the most common knee injuries is an anterior cruciate ligament sprain or tear.

Athletes who participate in high demand sports like soccer, football, and basketball are more likely to injure their anterior cruciate ligaments.

If you have injured your anterior cruciate ligament, you may require surgery to regain full function of your knee.

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AnatomyAnatomy

 

Normal knee anatomy, front view

Three bones meet to form your knee joint: your thighbone (femur), shinbone (tibia), and kneecap (patella). Your kneecap sits in front of the joint to provide some protection.

 

Bones are connected to other bones by ligaments. There are four primary ligaments in your knee. They act like strong ropes to hold the bones together and keep your knee stable.

Collateral Ligaments

These are found on the sides of your knee. The medial collateral ligament is on the inside and the lateral collateral ligament is on the outside.

Cruciate Ligaments

These are found inside your knee joint. They cross each other to form an "X" with the anterior cruciate ligament in front and the posterior cruciate ligament in back.

The anterior cruciate ligament runs diagonally in the middle of the knee. It prevents the tibia from sliding out in front of the femur, as well as provides rotational stability to the knee

Description

About half of all injuries to the anterior cruciate ligament occur along with damage to other structures in the knee, such as articular cartilage, meniscus, or other ligaments.

Injured ligaments are considered "sprains" and are graded on a severity scale.

Grade 1 Sprains. The ligament is mildly damaged in a Grade 1 Sprain. It has been slightly stretched, but is still able to help keep the knee joint stable.

Grade 2 Sprains. A Grade 2 Sprain stretches the ligament to the point where it becomes loose.

Grade 3 Sprains. This type of sprain is most commonly referred to as a complete tear of the ligament.

 

Partial tears of the anterior cruciate ligament are rare; most ACL injuries are complete or near complete tears.

Cause

The anterior cruciate ligament can be injured in several ways:

  • Changing direction rate

  • Stopping suddenly

  • Slowing down while running

  • Landing from a jump incorrectly

  • Direct contact or collision, such as a football tackle

Several studies have shown that female athletes have a higher incidence of ACL injury than male athletes in certain sports. It has been proposed that this is due to differences in physical conditioning, muscular strength, and neuromuscular control. lower extremity (leg) alignment, increased looseness in ligaments, and the effects of estrogen on ligament properties.

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Symptoms

When you injure your anterior cruciate ligament, you might hear a "popping" noise and you may feel your knee give out from under you.

  • Pain with risk. Within 24 hours, your knee will swell. If ignored, the swelling and pain may resolve on its own. Cushioning cartilage (meniscus) of your knee.

  • Loss of full range of motion

  • Tenderness along the joint line

  • Discomfort while walking

Doctor Examination

Physical Examination and Patient History

 

During your first visit, your doctor will ask about your symptoms and medical history. During the physical examination, your doctor will check the knee for any damaged structures and proceed by comparing it to the contralateral knee. Most ligament injuries are diagnosable on physical examination.

During your first visit, your doctor will talk to you about your symptoms and medical history.

During the physical examination, your doctor will check all the structures of your injured knee, and compare them to your non-injured knee.

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Imaging Tests

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Imaging tests help confirm the doctor's diagnosis.

Plain radiographs: X-ray cannot diagnose ACL injuries directly, but can show bone damage associated with the injury.

Imaging tests which may help your doctor confirm your diagnosis include:

X-rays. Although they will not show any injury to your anterior cruciate ligament, x-rays can show whether the injury is associated with a broken bone.

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 MRI is:

Magnetic resonance imaging (MRI) scan. This study creates better images of soft tissues like the anterior cruciate ligament. However, an MRI is usually not required to make the diagnosis of a torn ACL.

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Treatment

Treatment for an ACL tear will vary depending upon the patient's individual needs. For example, the young athlete involved in agility sports will most likely require surgery to safely return to sports. quieter lifestyle without surgery.

Nonsurgical treatment

A torn ACL will not heal without surgery. But nonsurgical treatment may be effective for patients who are elderly or have a very low activity level. If the overall stability of the knee is intact, your doctor may recommend simple, nonsurgical options.

Bracing. Your doctor may recommend a brace to protect your knee from instability. To further protect your knee, you may be given crutches to keep you from putting weight on your leg.

Physical therapy. As the swelling goes down, a careful rehabilitation program is started. Specific exercises will restore function to your knees and strengthen the leg muscles that support it.

Surgical treatments

Rebuilding the ligament. Most ACL tears cannot be sutured (stitched) back together. To surgically repair the ACL and restore knee stability, the ligament must be reconstructed. Your doctor will replace your torn ligament with a tissue This graft acts as a scaffolding for a new ligament to grow on.

Grafts can be obtained from several sources. Often they are taken from the patellar tendon, which runs between the kneecap and the shinbone. Hamstring tendons at the back of the thigh are a common source of grafts. kneecap into the thigh, is used. Finally, cadaver graft (allograft) can be used.

There are advantages and disadvantages to all graft sources. You should discuss graft choices with your own orthopedic surgeon to help determine which is best for you.

Because the regrowth takes time, it may be six months or more before an athlete can return to sports after surgery.

Procedure. Surgery to rebuild an anterior cruciate ligament is done with an arthroscope using small incisions. Arthroscopic surgery is less invasive. The benefits of less invasive techniques include less pain from surgery, less time spent in the hospital , and quicker recovery times.

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