About anterior cruciate ligament tear

What is anterior cruciate ligament tear?

Torn anterior cruciate ligament (ACL) facts

  • The anterior cruciate ligament is one of the four ligaments in the knee that provides stabilization.
  • Torn ACLs are a common knee injury.
  • An ACL tear or sprain occurs when a sudden change in direction or pivot occurs on a locked knee.
  • A pop, followed by pain and swelling of the knee are the most common symptoms of an ACL tear.
  • Women are more likely to tear their ACL because of differences in anatomy and muscle function.
  • Treatment goals are to return the patient to his or her preinjury level of function. Arthroscopic surgery may be required to reconstruct the torn ligament.
  • It may take six to nine months to return to normal activity after an ACL injury.

What is the function of the knee joint?

The purpose of the knee joint is to bend and straighten (flex and extend), allowing the body to change positions. The ability to bend at the knee makes activities like walking, running, jumping, standing, and sitting much easier and more efficient.

The thighbone (femur) and the shinbone (tibia) meet the kneecap (patella) to form the knee joint. The rounded ends of the femur, or condyles, line up with the flat tops of the tibia called the plateaus. There are a variety of structures that hold the knee joint stable and allow the condyles and plateaus to maintain their anatomic relationship so that the knee can glide easily through its range of motion. The knee is a hinge joint, but there is also some rotation that occurs when it bends and straightens.

There are four thick bands of tissue, called ligaments, that stabilize the knee and keep its movement in one plane.

  • The medial collateral ligament (MCL) and the lateral collateral ligament (LCL) stabilize the sides of the knee preventing side to side buckling.
  • The anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) form an X on the inside of the knee joint and prevent the knee from sliding back to front and front to back respectively.

The major muscles of the thigh also act as stabilizers: the quadriceps in the front of the leg and the hamstrings in the back.

A sprain occurs when a ligament is injured and the fibers are either stretched or torn. A first-degree sprain is a ligament that is stretched but with no fibers torn, while a second-degree sprain is a partially torn ligament. A third-degree sprain is a completely torn ligament.

What is a torn anterior cruciate ligament (ACL)?

A torn anterior cruciate ligament (ACL) is a second- or third-degree sprain of the ACL. The ACL arises from the front of the medial femoral condyle and passes through the middle of the knee to attach between the bony outcroppings (called the tibia spine) that are located between the tibia plateaus. It is a small structure, less than 1 ½ inches long and ½ inch wide. The anterior cruciate ligament is vital in preventing the thighbone (femur) from sliding backward on the tibia (or, from the other point of view, the tibia sliding forward under the femur). The ACL also stabilizes the knee from rotating, the motion that occurs when the foot is planted and the leg pivots.

Without a normal ACL, the knee becomes unstable and can buckle, especially when the leg is planted and attempts are made to stop or turn quickly.

What are the symptoms for anterior cruciate ligament tear?

Seek immediate care if any injury to your knee causes signs or symptoms of an ACL injury. The knee joint is a complex structure of bones, ligaments, tendons and other tissues that work together. It's important to get a prompt and accurate diagnosis to determine the severity of the injury and get proper treatment.

What are the causes for anterior cruciate ligament tear?

Ligaments are strong bands of tissue that connect one bone to another. The ACL, one of two ligaments that cross in the middle of the knee, connects your thighbone to your shinbone and helps stabilize your knee joint.

ACL injuries often happen during sports and fitness activities that can put stress on the knee:

  • Suddenly slowing down and changing direction (cutting)
  • Pivoting with your foot firmly planted
  • Landing awkwardly from a jump
  • Stopping suddenly
  • Receiving a direct blow to the knee or having a collision, such as a football tackle

When the ligament is damaged, there is usually a partial or complete tear of the tissue. A mild injury may stretch the ligament but leave it intact.

What are the treatments for anterior cruciate ligament tear?

Prompt first-aid care can reduce pain and swell immediately after an injury to your knee. Follow the R.I.C.E. model of self-care at home:

  • Rest. General rest is necessary for healing and limits weight bearing on your knee.
  • Ice. When you're awake, try to ice your knee at least every two hours for 20 minutes at a time.
  • Compression. Wrap an elastic bandage or compression wrap around your knee.
  • Elevation. Lie down with your knee propped up on pillows.

Rehabilitation

Medical treatment for an ACL injury begins with several weeks of rehabilitative therapy. A physical therapist will teach you exercises that you will perform either with continued supervision or at home. You may also wear a brace to stabilize your knee and use crutches for a while to avoid putting weight on your knee.

The goal of rehabilitation is to reduce pain and swelling, restore your knee's full range of motion, and strengthen muscles. This course of physical therapy may successfully treat an ACL injury for individuals who are relatively inactive, engage in moderate exercise and recreational activities, or play sports that put less stress on the knees.

Surgery

Your doctor may recommend surgery if:

  • You're an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting
  • More than one ligament or the fibrous cartilage in your knee also is injured
  • The injury is causing your knee to buckle during everyday activities

During ACL reconstruction, the surgeon removes the damaged ligament and replaces it with a segment of tendon — tissue similar to a ligament that connects muscle to bone. This replacement tissue is called a graft.

Your surgeon will use a piece of tendon from another part of your knee or a tendon from a deceased donor.

After surgery you'll resume another course of rehabilitative therapy. Successful ACL reconstruction paired with rigorous rehabilitation can usually restore stability and function to your knee.

There's no set time frame for athletes to return to play. Recent research indicates that up to one-third of athletes sustain another tear in the same or opposite knee within two years. A longer recovery period may reduce the risk of re-injury.

In general, it takes as long as a year or more before athletes can safely return to play. Doctors and physical therapists will perform tests to gauge your knee's stability, strength, function and readiness to return to sports activities at various intervals during your rehabilitation. It's important to ensure that strength, stability and movement patterns are optimized before you return to an activity with a risk of ACL injury.

What are the risk factors for anterior cruciate ligament tear?

There are a number of factors that increase your risk of an ACL injury, including:

  • Being female — possibly due to differences in anatomy, muscle strength and hormonal influences
  • Participating in certain sports, such as soccer, football, basketball, gymnastics and downhill skiing
  • Poor conditioning
  • Using faulty movement patterns, such as moving the knees inward during a squat
  • Wearing footwear that doesn't fit properly
  • Using poorly maintained sports equipment, such as ski bindings that aren't adjusted properly
  • Playing on artificial turf

Is there a cure/medications for anterior cruciate ligament tear?

The anterior cruciate ligament (ACL) is one of the key ligaments that help stabilize the knee joint. The ACL connects the femur to the shinbone or the tibia. Anterior cruciate ligament tear is most commonly torn during sports that involve sudden stops and changes in direction.
Prompt first-aid care can reduce pain and swelling immediately after an injury to your knee. Follow the R.I.C.E. model of self-care at home:
1. Rest
2. Ice pack
3. Compression
4. Elevation

Apart from this, patients may need extensive treatments that include,
1. Rehabilitation
Medical treatment for an ACL injury begins with several weeks of rehabilitative therapy. A physical therapist will teach you exercises that you will perform either with continued supervision or at home.
The goal of rehabilitation is to reduce pain and swelling, restore your knee's full range of motion, and strengthen muscles.
This course of physical therapy may successfully treat an ACL injury for individuals who are relatively inactive, engage in moderate exercise and recreational activities, or play sports that put less stress on the knees.
2. Surgery
The doctor may recommend surgery if:

  • Patient is an athlete and wants to continue in your sport, especially if the sport involves jumping, cutting or pivoting
  • More than one ligament or the fibrous cartilage in your knee also is injured
  • The injury is causing your knee to buckle during everyday activities
During ACL reconstruction, the surgeon removes the damaged ligament and replaces it with a segment of tendon — tissue similar to a ligament that connects muscle to bone. This replacement tissue is called a graft.

Symptoms
A loud pop or a "popping" sensation in the knee,Severe pain and inability to continue the activity,Rapid swelling
Conditions
Loss of range of motion,A feeling of instability
Drugs
Physical therapy,Steroid therapy,Rehabilitation,Surgery

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