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The ACL (Anterior Cruciate Ligament) is located at the front of the knee joint is is one of the most important ligaments within the joint in that it is responsible for stability, helping you to walk, run and jump. It also works to prevent the knee cap from moving forward beyond its normal range of motion.
The ACL (Anterior Cruciate Ligament) is situated deep inside the knee joint and a tear of the ACL is a very common sports injury, with 40% incurred following participation in extreme sports. This often occurs as a result of landing when the knee is twisted or over extended - most usually in contact sports including basketball and football. The damage to the ACL can occur in several scenarios in sport including coming to an abrupt stop, landing awkwardly, direct contact or a sudden change in direction. This type of injury is reported more frequently in women.
ACL injuries are headline news in professional sport. You just have to run a search in Google to find all the Premier League players past and present who have succumbed to such an injury along with their respective rehabilitation which can be anything up to 9 months. It is also big news in the United States with American Footballers.
An anterior cruciate ligament rupture often presents itself as knee pain, a ‘snapping’ or ‘popping’ sensation, tenderness plus swelling and difficulty in walking within 24 hours of the injury occurring. If left untreated the knee may remain unstable, and you may risk more extensive damage to the meniscus (the soft cartilage) within the knee, so it is important to seek medical advice as soon as possible. Using a knee support is advisable until you have a firm diagnosis of your particular grade of acl injury.
Most acl knee injury can be diagnosed through a thorough examination by a doctor, who will typically compare the injured knee to the uninjured one. In certain cases further tests to rule out an associated broken bone will be undertaken. This might be an x-ray or an MRI scan which can provide a high resolution image showing the extent of the knee ligament damage.
There are varying degrees of severity, from grade one to a grade three with the treatment options offered varying as a result. A grade one is a mild sprain and will repair itself following a few days of rest. A grade two results in a minor tear of the ligament which can take a number of weeks to heal and should be combined with physiotherapy to help strengthen the joint once again prior to restarting your activity. A grade three is a complete rupture of the ligament which can require surgery to remedy, though conservative treatment is available through physiotherapy and the use of a knee brace for additional stability.
For those wishing to continue their sporting pursuits, an operation to reconstruct the ACL is often recommended, in order to regain total knee function. The decision to go down the surgical route will depend on a number of factors including the patient’s general health and the severity of the condition. Most ligament tears cannot be stitched (sutured) back together. They will require reconstruction using a tissue graft, which will normally be taken from either the patellar tendon (the tendon between the knee and shin bones) or the hamstring. The site of the graft will depend on the individual patient. This graft is effectively ‘scaffolding’, supporting the growth of a new ligament. After surgery, the patient will undertake an intensive period of physical therapy and rehabilitation. It may be six months or more before an athlete is able to return to training. An alternative, less invasive surgical procedure is carried out through small incisions using an arthoscope. Recovery time tends to be swifter in such cases.
An anterior cruciate ligament rupture or tear is highly unlikely to heal fully without surgery. However, nonsurgical options may be appropriate for elderly or sedentary patients. If the knee has retained its basic stability, there are several options to choose from. These include the wearing of a special brace or knee support to keep the area stable and lessen the risk of further knee ligament damage. The use of crutches may be recommended to keep weight off the knee. Once the swelling has subsided, a gentle programme of rehabilitation can be commenced, typically including some gentle strengthen exercises to improve the strength of the muscles in the leg.
Knee braces come in a variety of styles, all designed to manage a variety of different conditions. Before you make a purchae it is important to ensure you are selecting a brace capable of managing the injury and degree of severity you have been diagnosed with. There are two types of ligament braces, the choice is typically dependant on the severity of the injury. Following mild to moderate ligament damage then a hinged support will normally suffice. This type of knee brace offers both compression through the material used in its design and stability via the hinge and the straps, with the straps effectively acting as external ligaments to help you when mobile. Following a more severe ligament injury you may consider a rigid brace which offers stability and protection when mobile. Such braces are typically manufactured from material such as carbon fibre and often used by those partaking in extreme sports, where protection of the knee is crucial. Following surgery on a damaged ACL there will be abn inherent weakness in the joint and the last thing you want is to damage your knee again, hence the increased use of this type of bracing.