ANTERIOR CRUCIATE LIGAMENT TEAR
Another very common knee injury is anterior cruciate ligament tear. ACL tear symptoms include severe pain and instability of the joint. ACL tear treatment depends on age and level of the patient`s activity. Read about methods of diagnostics, symptoms and ACL tear treatment options below.
Your knee joint connects the thighbone (femur), shinbone (tibia) and calf bone (fibula) and the kneecap (patella) at the front for protection. The ligaments act as connectors between your bones as well as providing stability to keep your knee secure. There are four main ligaments in the knee joints as per below.
- Medial collateral ligaments (MCL)
- Lateral collateral ligaments (LCL)
- Anterior cruciate ligaments (ACL)
- Posterior cruciate ligaments (PCL)
The Anterior Cruciate Ligament (ACL) connects your thighbone to the shinbone in the middle of your knee. It ensures that the shinbone remains in line with your thighbone and allows for rotation of the knee.
ARE ACL CONNECTED TO OTHER KNEE INJURIES?
Majority of the injuries to the ACL are connected with other injuries to the knee, which could be the problems with articular cartilage, meniscus or other ligaments. Injuries to a ligament are referred to as “sprains” and are grouped in three grades that represent the level of severity.
- Grade 1 Sprains: The knee joint is still stable, but the ligament is mildly damaged and slightly stretched.
- Grade 2 Sprains: Ligament is stretched to the point where it is not strained anymore. This is also called a partial tear of the ligament. Such sprains are very rare, as most ACL injuries are almost complete tears.
- Grade 3 Sprains: The knee joint is unstable due to a complete tear of the ligament.
ACL TEAR SYMPTOMS
- Snapping or popping sound in the knee
- Not able to continue activity
- Intense pain
- Heavy swelling within a couple hours
- Loss of mobility
- Instability of the knee
Be cautious and listen to your body:
- If you do not feel comfortable to move you knee, you might have a serious underlying injury. So you should refrain from moving your knee.
- In case of doubt, you can straighten your knee with a splint until a medical professional attends to you and stop your activity immediately.
ACL TEAR TREATMENT OPTIONS
The treatment and recovery from Anterior Cruciate Ligament (ACL) tear will depend on the patient’s needs. For example, an active teen will perhaps need surgery in order to accommodate his or her active lifestyle, especially if he or she is doing sports professionally. But an older, less active patient might suffice with a less invasive treatment.
NON-SURGICAL ACL TEAR TREATMENT OPTIONS:
Non-surgical treatments can heal Grade 1 and 2 sprains, when the knee is still stable. However, a complete tear of ACL cannot heal properly without surgery. The type of treatment that is right for you depends on your level of activity. However, non-operative treatments are very effective for older or less active patients. Non-surgical treatments include:
- Bracing: Protecting, stabilizing and securing the motion of your knee with a brace. In addition, crutches can help prevent you from putting weight on that knee.
- Physical therapy: After the initial swelling subsides, your physical therapy program will focus on rehabilitation. This will restore the function of your knee and further strengthen the muscles in your leg.
SURGICAL ACL TEAR TREATMENT OPTIONS
The ACL is reconstructed by replacing the damaged ligament with replacement grafts made of tendons. A tendon is very similar to a ligament as it is the tissue that connects the muscle to the bone. A graft is simply a piece of tissue that is taken from another part of your knee and used to replace the ligament. In the past, a suture was used to stitch the parts of damaged ACL back together but this approach has shown to be less successful. During the surgery, the doctor will use an arthroscope to insert a small camera in your joint. By inserting small instruments via another incision, the procedure will be executed. A tendon from another part of your knee or from a deceased donor will serve as scaffolding for new ligament tissue to grow. A few small incisions will be made on your knee and it will be filled with sterile solution to rinse away cloudy fluid. This will give your surgeon a better view of what’s going on in your knee. The image produced by the arthroscope will be used to guide the surgeon. Small instruments will then be inserted through another small incision to extract the autograft and reconstruct your ACL.
Rehabilitation is essential for full recovery, regardless if you have undergone a surgery or not. A program will be provided to strengthen your knee and help you to gain more mobility. After-surgery rehabilitation program will initially focus on the mobility of the knee joint and the surrounding muscles. The second focus area for the program is to gain strength and to protect the new ligament. Finally the program will focus on specific functionalities that one requires for their specific needs.
DIAGNOSING AN ACL INJURY
- History taking: An examination on current symptoms, recent injuries, current use of medications, your medical and your family’s medical history.
- Physical examination: A thorough physical examination of your knee joint to diagnose the Anterior Cruciate Ligament (ACL) tear. Swelling, range of motion, tenderness and the structure of your injured knee will be checked and compared to that of your uninjured knee.
- X-rays: This will rule out any bone fractures. But note that X-rays do not image soft tissues, such as the ligament.
- Magnetic Resonance Imaging (MRI): MRI is used to provide more information on the patient’s situation, as it produces a better image that includes bones, cartilage and other soft tissues. An MRI will show the tear of the ACL in more detail.
- Ultrasound: An ultrasound will more often be used to find out if there is any damage to ligaments, tendons and muscles.