The knee ACL, or anterior cruciate ligament is a key stabilising ligament of the knee. It prevents the shin bone (tibia) from excessively moving forward or anteriorly in relation to the femur (thigh bone). It is also in resists rotation force between these bone ends.
Knee ACL tear is a common injury that occurs in many sports. Ligament injuries occur when the joint disruption forces exceed the forces supplied by the supporting muscle and ligaments. Knee ACL injuries can be either a grade 1 sprain where a few fibres of ligament are torn and there is minimal ligament laxity. A grade 2 knee ACL injury occurs when more ligament fibres are damaged and there is moderate joint laxity. A grade 3 injury, or ACL rupture is when all the fibres are completely torn through. With knee ACL rupture the patient will often describe that they planted their foot, twisted their body, and heard a pop. They are often unable to put weight on the leg initially, and can get significant swelling. When they can put weight through the leg they describe a sense of instability, or a feeling their knee will give way on them, especially with change of direction.
It is very important for anyone who suspects they may have injured their knee ACL that they immediately Rest, Ice, Compress, Support and get a diagnosis from a knee specialist, sports physician, or physiotherapist as soon as possible.
In all cases the patient needs to see a physiotherapist for strapping and bracing support, restore range of motion strength and stability. This is vital to optimise recovery, prevent recurrence and assist in preventing post-traumatic arthritis.
In the case of knee ACL rupture, patients need to see a knee specialist orthopaedic surgeon. Most patients will benefit from surgical reconstruction of the ACL, using a hamstring or patella tendon graft. There is a lengthy post-operative rehabilitation process of at least six months of guided physiotherapy home and gym-based rehabilitation.
All ACL injury patients should go through a guided rehabilitation regime and use braces and strapping to stabilise their joint, especially in the early stages to prevent arthritis later on. Instability of the joint, causes excessive movement, accelerated cartilage wearing and can lead to arthritis. Those with knee ACL injuries who have developed arthritis, aching joint pain, morning stiffness, pain in cold weather, or feel older than they should seek more help for their joint pain.
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