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Anterior Cruciate Ligament (ACL) Injury9th August 2018
An ACL injury can be caused by a direct impact to the knee, landing incorrectly after a jump, a sudden twist or turn in the knee or excessive pressure on the knee. It is particularly common in certain sports, including football, rugby and hockey.
An injury can range from a minor sprain to a total tear of the ligament with treatments ranging from physiotherapy to surgery. Furthermore, an ACL injury is likely to cause additional damage to the meniscus and articular cartilage. Injuries can be minimised by staying active and following exercises correctly.
Measuring an ACL Injury
There are three grades of severity when diagnosing an ACL injury:
- Grade 1 - This is usually when the ligament has been stretched causing instability in the knee joint, i.e. a sprain. Damage is usually relatively mild.
- Grade 2 - This is usually a partial tear of the ligament where it has stretched to a point that it is left loose causing a weakness in the knees integrity and instability.
- Grade 3 - This usually refers to a full rupture of the ligament, meaning the knee is left completely unstable because the ligament has split in two or detached from the bone.
There are three grades of severity when diagnosing an ACL injury
Symptoms of an ACL Injury
Many patients report a “popping” sounds when they have suffered an ACL injury. But other symptoms can include swelling, a feeling that the knee is giving way, discomfort and tenderness. You will also notice a lack of movement as the function of the knee can be inhibited by an ACL injury.
If you think you have suffered an ACL injury, you should be wary about returning to activity straight away and should probably get it checked out by your GP. Most GPs are able to diagnose an ACL injury just by touch and sight alone; however, if it is proving difficult you will be sent for an MRI (magnetic resonance imaging) scan.
Continuing to stay active on your knee may cause further damage, which can lengthen the recovery process and cause problems later in life.
Due to the nature of the injury, it can be difficult to provide effective measures of prevention. However, there are some helpful tips that can reduce the chances of an injury occurring. If you have an active lifestyle, making sure you have effective warm-up and cool down sessions before and after exercise will ease the strain put on knee joints. This will also reduce the buildup of lactic acid, which can inhibit your mobility. Pilates and yoga have also proven effective in keeping the knee joint supple.
Due to most ACL injuries being a tear, the most likely type of treatment is keyhole surgery, or arthroscopy. To read more about this type of surgery, click here. If the ligament has come away from the bone, simply stitching it back on will not be a permanent, long-term fix, instead, a substitute graft of the tendon will be used to provide knee stability for longer. This can usually be taken by a tendon autograft from your patellar, quadricep or hamstring.
Before surgery can take place, the swelling must have gone down somewhat, allowing for some motion to return. Operations that are performed too early leave it more likely a scar will form, which increases the chances of you losing the knee joint’s motion.
Surgery is not the only treatment available for ACL injuries. It should be combined with extensive rehabilitation afterwards as this will keep the motion of the knee effective and strengthen the knee joint. Physiotherapy will help to return movement to the affected knee joint while a strengthening programme will be provided to ensure the new ligament is strong and able to cope with activities. Each programme will be tailor made to help a successful return to your lifestyle.
Bracing may also be an option to give an extra layer of protection and support for the knee. You may require crutches initially to help keep the weight off the knee until it’s strong enough to support itself.
The recovery process can be quite lengthy and if you are to avoid further damage, it is important to be patient.