Sports related injuries, specifically the ligamentous injuries to the knee, are quite common these days, thanks to the dramatic increase in young population's interest and participation in sports.
Of the sports-related injuries, particularly to the lower limbs, rupture of the Anterior Cruciate Ligament (ACL) is the most common, accounting for approximately 200,000 injuries in the United States annually.
ACL
Anyone thinking about undergoing surgery for ACL rupture should understand what exactly ACL is. It is one of four major ligaments (strong bands of tissue) that connect the three knee bones- the femur (thigh bone), the tibia (shin bone), and the patella (knee cap), which together form the bone structure of the knee joint. This knee joint is held together by the anterior cruciate (ACL), medial collateral (MCL), lateral collateral (LCL), and posterior cruciate (PCL) ligaments.
Made of multiple non-parallel fibers, ACL is a broad ligament that joins the femur and the tibia bones. It controls backward and forward range of motion of the lower leg, controls the rotational movements of the knee and provides mechanical stability to the knee.
ACL Injury
The commonest cause of ACL rupture is a sharp or sudden change in the force being applied to the knee joint during sports activities. A ligament can be damaged if the knee is sharply twisted or extended beyond its normal range of motion. This may occur either on the football field, after fall on the snow fields or in a motor vehicle accident.
ACL injuries can range from mild (small tears) to severe (complete ACL tear), and cause swelling, extensive knee pain and instability in the knee.
While partially torn ACL can be restored to its pre-injury state through progressive physical therapy and rehabilitation, surgical intervention is usually advised in cases where the knee has suffered combined injuries i.e. ACL tear or rupture in combination with other injuries in the meniscus, articular cartilage, or other ligaments.
Nonsurgical Treatment
In non-operative treatment, physical therapy combined with patient education can help patients restore their knee to a condition close to its pre-injury state.
In the ACL tears rehab program patients are taught how to avoid knee instability problems and maintain range of motion. They learn strengthening exercises to regain stability by improving their muscle strength.
A knee brace may be involved in non surgical treatment, especially for those who want to return to sports. Standard ACL rehab often takes 7 to 9 months until full strength and function of the ruptured knee are restored.
Nonsurgical treatment is likely to be successful in patients who suffered partial tears and no instability symptoms. Those who are willing to give up high-demand sports and live sedentary lifestyles may simply consider ACL rehab program.
Surgical Intervention
Surgical reconstruction of the ACL is usually advised to patients dealing with combined injuries.
A torn ACL is not usually repaired using suture to sew it back to the bone, because repaired ACL may fail over time. Therefore, it is necessary to completely replace the injured ligament with a by a substitute graft made of tendon taken from another part of the body or external source.
Patients with a torn ACL and significant functional instability often remain at a significantly high risk of developing secondary knee damage and should, therefore, consider ACL reconstruction surgery.
By some estimates, approximately 100,000 ACL reconstruction surgeries are performed each year in the United States. Patients who undergo ACL reconstruction surgery show impressive long-term success rate, up to 95 percent in most cases.
If you do opt to have surgery as your main treatment for combined ligament injuries, you can expect to undergo at least four months of physical therapy and rehabilitation afterward.
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