About ACL (Anterior Cruciate Ligament)
What are the causes of an ACL injury?
Are women at higher risk of ACL injury?
How can one prevent an ACL injury?
How will I know if I have a torn ACL?
Will a torn ligament heal itself? Can a torn ACL be repaired?
What is the benefit of ACL reconstruction surgery?
What if I do not undergo surgery?
Does that mean that a person can not lead a normal life without surgery?
So when should I select the option of undergoing surgery?
How much physical therapy will I need after the ACL reconstruction?
The Anterior Cruciate Ligament (ACL) is one of four ligaments that provide stability to the knee joint. It is a band of fibers that keep leg bone (Tibia) sliding forward from the thigh bone (Femur). ACL injury is the one most common ligament injuries around the knee joint.
What are the causes of an ACL injury?
ACL injuries occurs more commonly after a moderate to high velocity trauma along with rotational force on the knee. (for example, when the feet are planted one way and the knees are turned another way) or when landing from a jump.
(Courtesy ADAM)
Sports like football, soccer etc are common sports. Most are non-contact injuries that occur during sudden twisting motion
Other common cause of ACL injuries is fall from bike, motorbike.
Are women at higher risk of ACL injury?
Women are nearly three times more likely to have ACL injuries than men. Some research has shown that a female soccer player is eight times more likely to injury her ACL than a male soccer player. Female Hormones, wider pelvis, different biomechanics and less dedicated training are the different reasons attributed to it.
How can one prevent an ACL injury?
A training program that concentrate on balance, power and agility; will go a long way in preventing ACL injuries. This program improves neuromuscular coordination, muscular reaction time & proprioceptive sensations. ACL conditioning program is a must for sports persons.
Saumya Orthocare: Center for Advanced Surgeries of the Knee Joint, Ahmedabad, India offers a dedicated "ACL Injury Prevention Program" for Sports persons. Please contact the center for the details of the program.
How will I know if I have a torn ACL?
You must have an episode of injury that you can link with your problem. A sports injury, a fall from bike, Road Traffic Accident are the usual causes. The injury is followed by swelling and pain in the knee joint. Gradually pain and swelling subside, but "Unstable Knee" develops. Unstable Knee means you will feel that your knee is give way or feel as if it will give way. You losse confidence in day to day activities, more so in high demand activities. You will have falling tendency or you may actually fall, while suddenly turning during a walk, catching a bus, jumping out of a car etc. It may stop you doing your normal work and sports.
Will a torn ligament heal itself? Can a torn ACL be repaired?
The ligament will not heal if it is torn. It cannot be repaired but may be reconstructed by a key hole surgery (Arthroscopy).
What is the benefit of ACL reconstruction surgery?
The operation should make your knee stable again. Your knee will not feel as if it is going to give way. You will regain confidence in your knee again and will be able to do high demand activities again. Reconstructing your ligament may also reduce the chance of arthritis in your knee when you are older.
What if I do not undergo surgery?
Without an operation, your ligament will not repair itself. Your knee may become more unstable with time and suffer further damage, perhaps leading to arthritis at a very young age.
It may stop you doing your normal work and sports.
It might lead to another unexpected fall leading to more injuries to your body.
In some cases of ACL tear, patient may not feel his knee to be unstable. This happens because his muscles around knee are strong enough to keep knee stable. Such cases may not require or may not demand treatment.
There are few cases, when patient doesn't know that he has a torn ligament. Obviously such patient may not demand any treatment, forget surgery.
However, this doesn't mean that these patient will not develop early age arthritis.
So when should I select the option of undergoing surgery?
You should have the ACL reconstruction if your ligament is completely torn and:
Wouldn't a plain x-ray be much less expensive and less time-consuming?
The X-ray only shows bones and not the ligaments and other soft tissue structures of the Knee Joint. MRI is must, if you want to see a torn ligament before surgery. However, your surgeon after a detailed clinical examination, may not order a MRI. He may be totally convinced about your ACL tear with clinical examination.
How much physical therapy will I need after the ACL reconstruction?
One of the main priorities after ACL reconstruction is to regain the knee range of motion. This, along with establishing a good strengthening program, a proprioceptive training program is must. One should expect 4- 6 months of physiotherapy after an ACL reconstruction.