Anterior Cruciate Ligament Injuries

Anterior Cruciate Ligament Injuries

The anterior cruciate ligament is the most commonly injured ligament in the knee. It is within the knee providing both front to back as well as rotational stability to the knee.

Injury and Symptoms
It is mostly injured while playing pivoting sports like football, basketball, kabaddi amongst others. It is also commonly seen after road accidents, especially, when there is a sudden fall from a bike with the injured leg hitting the ground first. At the time of injury, the patient can hear a loud pop with immediate pain and swelling in the knee. It is associated with instability in activities preventing return to normal activities and sports.
Treatment Options
In certain selected patients, non-surgical treatment with physical therapy, braces and activity modifications is possible. For majority young patients wishing to return to sports, surgical treatment in the form of an arthroscopic ACL reconstruction is the treatment of choice.
Arthroscopic ACL reconstruction
This procedure is performed using arthroscopy, i.e. keyhole surgical technique. It involves making a new ACL ligament. It is usually done using the patients own tendons like the hamstring tendon, patella tendon, quadriceps tendon or the peroneal longus tendon. The choice of tendon is dependent on a variety of factors like the patient age, expected activity level, type of sport, anatomy of the patient, high risk factors, concomitant meniscus or other ligament injuries. Concomitant meniscal injuries and other ligament injuries are very important to identify as they will affect the outcomes of an ACL reconstruction. In patients with certain high risk factors and increased rotational instability, an extra augmentation procedure called a lateral extra articular tenodesis is required to reduce the risk of failure or re injury of the ACL reconstruction. Lastly, there are multiple techniques available to perform an ACL reconstruction which will again vary from patient to patient based on anatomy and graft type.
In summary, ACL reconstruction is the gold standard surgical choice. The type of graft for reconstruction and need for extra augmentation procedures is personalized and has to be made based on patient expectations, symptoms, activity levels and anatomy.
Recovery from ACL Reconstruction
The recovery from an ACL reconstruction requires diligent physiotherapy with gradual progression as directed by your doctor. After an ACL reconstruction, one can return to any sport of choice or activity as desired.

Consult your doctor to formulate a treatment plan for your personalized needs.