Anterior Cruciate Ligament Injury
Introduction: Anterior cruciate ligament is one of the many ligaments which are integral parts of the knee joint.
The knee joint is a complex structure which is involved in most activities in daily life as well as in sports.
Strong as well as supple movements are a key to improved performance.
Ligaments are basically structures of fibrous tissue involved in holding bones together around a particular joint.
Likewise, the anterior cruciate ligament or the ACL connects the femur (long bone of the thigh) to the tibia (main bone of the leg).
It prevents the anterior movement of the tibia on the femur.
Additionally, it also antero-lateral rotation of the knee.
Mechanism of injury to the ACL: Usually, a valgus force (from outside to inside of knee) along with twisting and hyperextension of the knee causes ACL injury.
Usually, occurs in contacts sports; however more common in women in non contact sports or activities.
ACL injury usually does not occur on its own.
It is accompanied by collateral ligament as well as meniscal damage (other ligaments of the knee joint).
Symptomatology: 'Audible pop' i.
e.
pop is heard at the time of injury.
Swelling of the knee with collection of blood within the knee Intense pain in the knee Clinical Diagnosis: signs of ACL laxity: Pivot shift test is positive reduction of extension Treatment: ACL injuries usually occur in sports involving pivot movements around the knee.
If the athlete wishes to continue pursuing their careers, reconstruction is usually recommended.
Indications: associated meniscal or medical collateral tears children/ adolescents unstable knee even after completion of rehab Surgery: Surgery is recommended within 3 weeks post surgery unless rehab is indicated.
Aim is to repair the torn ACL using either the semitendinosus or gracilis tendon or middle third of the patellar tendon.
However, there is no evidence to suggest that ACL repair will in the long term reduce the incidence of osteoarthritis of the knee.
Rehabilitation of ACL injury: Indicated either post injury or post surgery.
Early mobilisation with brace protection is usually the initial line of action.
Strengthening and proprioceptive exercises are commenced within days rather than weeks.
With rehab, return to sports is possible within 20 weeks.
The knee joint is a complex structure which is involved in most activities in daily life as well as in sports.
Strong as well as supple movements are a key to improved performance.
Ligaments are basically structures of fibrous tissue involved in holding bones together around a particular joint.
Likewise, the anterior cruciate ligament or the ACL connects the femur (long bone of the thigh) to the tibia (main bone of the leg).
It prevents the anterior movement of the tibia on the femur.
Additionally, it also antero-lateral rotation of the knee.
Mechanism of injury to the ACL: Usually, a valgus force (from outside to inside of knee) along with twisting and hyperextension of the knee causes ACL injury.
Usually, occurs in contacts sports; however more common in women in non contact sports or activities.
ACL injury usually does not occur on its own.
It is accompanied by collateral ligament as well as meniscal damage (other ligaments of the knee joint).
Symptomatology: 'Audible pop' i.
e.
pop is heard at the time of injury.
Swelling of the knee with collection of blood within the knee Intense pain in the knee Clinical Diagnosis: signs of ACL laxity: Pivot shift test is positive reduction of extension Treatment: ACL injuries usually occur in sports involving pivot movements around the knee.
If the athlete wishes to continue pursuing their careers, reconstruction is usually recommended.
Indications: associated meniscal or medical collateral tears children/ adolescents unstable knee even after completion of rehab Surgery: Surgery is recommended within 3 weeks post surgery unless rehab is indicated.
Aim is to repair the torn ACL using either the semitendinosus or gracilis tendon or middle third of the patellar tendon.
However, there is no evidence to suggest that ACL repair will in the long term reduce the incidence of osteoarthritis of the knee.
Rehabilitation of ACL injury: Indicated either post injury or post surgery.
Early mobilisation with brace protection is usually the initial line of action.
Strengthening and proprioceptive exercises are commenced within days rather than weeks.
With rehab, return to sports is possible within 20 weeks.
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