ACL, Knee Joint WaranaSeptember 17, 2010
The anterior cruciate ligament is in the centre of the knee joint where it connects the femur (thighbone) to the tibia (shinbone). It controls forwards movement of the tibia on the femur. If the tibia moves too far forwards, it can rupture the ACL. Sports-related injuries are the most common and usually occur when landing from a jump, pivoting, sudden deceleration (slowing down or stop) or hyperextension. It can also occur when another player falls across the knee. When the ACL is damaged, associated injuries can occur to the Medial Collateral Ligament (MCL), medial or lateral meniscus or an avulsion fracture of the tibial plateau where the ACL attaches.
At the time of injury, an audible pop/ crack may be heard with a feeling of giving way. There is usually pain and an inability to continue activity with swelling occurring within a short time from the injury. Residual restriction of movement and tenderness on palpation can occur. Diagnosis is most accurate with MRI however there are some physical tests a Physiotherapist/ Orthopod can perform to test the ACL and identify other damaged structures.
Treatment options are dependent on many factors such as associated injuries, demands on the knee and degree of instability. Surgical treatment involves replacing the torn ACL with a graft (from your own tendon) that reproduces the ligaments normal function. Post-operatively, the patient progresses through a rehabilitation of about 6-9 months working on movement, decreasing swelling, strengthening, balance, walking and later on returning to sport. Non-surgical management includes the same type of rehabilitation that occurs post-surgery.