What and where is the anterior cruciate ligament (ACL)?
The ACL is a ligament in the middle of the knee that connects the tibia (shinbone) to the femur (thighbone).
How does the ACL get injured?
The anterior cruciate ligament is generally torn in a noncontact situation where excessive forces are placed on the knee and the tibia is twisted under the femur causing a complete rupture (tear) of the ACL. This commonly is seen with twisting, stopping, turning sports such as football, volleyball, basketball, and soccer. It can also happen in contact sports with a blow to the knee.
What kind of symptoms would I have if I damaged the ACL?
Symptoms with a damaged ACL will be pain, swelling and a feeling of instability. Often times the knee can buckle underneath you and “give way.” If twisting, stopping, turning sports are attempted with a torn ACL, these buckling and “giving way” episodes will recur.
Does it heal on its own?
The ACL does not heal on it’s own and younger patients (< 40), who wish to participate in twisting, stopping, turning sports need to have this fixed (an ACL reconstruction). Repetitive “giving way” episodes of the knee with an anterior cruciate tear can harm the articular cartilage surface of the femur and tibia, and possibly tear the meniscus. These additional associated injuries can lead to painful arthritis in the future.
How do I know if I need to have surgery?
You should have surgery if you want to play twisting, stopping, turning sports like basketball, soccer, rugby, lacrosse, football, hockey, and rock climbing or if you have continued “giving way” episodes in your daily activities. Another reason for surgery would be to stabilize the knee, which minimizes further damage to the articular cartilage or meniscus.
What’s the technique for ACL reconstruction?
It is widely accepted that the best substitute for one’s ACL is to use an autologous graft, which means another tissue such as a ligament or tendon, taken from your own body. The autologous graft most usually used is that of the hamstrings or patellar tendon. These are the muscles in the back of the thigh that run from the hips down to the knees. The graft most commonly used are that of semitendinosus and gracilis. Allograft (tissue bank cadaver tissue) tissue is sometimes used. Both autograft and allograft tendons are acceptable to use for ACL reconstructions.
Are other surgerys required after ACL Reconstruction, to remove screws or to make adjustments?
Occasionally surgery is necessary for stiffness. That is now very unlikely if you scrupulously follow the accelerated rehabilitation program.If screws irritate itsunderlying tissues which rarely happens , removal may be required.
What is the recovery / rehabilitation like?
Recovery is generally excellent for the ACL reconstruction. But post operative exercise training is mandatory. There is a routine protocol for post operative ACL reconstruction.
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