ACL Injury and Repair
An anterior cruciate ligament (ACL) sprain or tear is one of the most common knee injuries. High demand sports, such as soccer, football, basketball, or hockey, can increase the likelihood of an ACL injury.
An ACL tear has the potential to limit a person’s mobility and can become extremely painful. Surgery will likely be necessary to make a full recovery; however, specific treatment plans are determined by the severity of the injury.
With the help of surgery and physical therapy, a majority of patients suffering from an ACL injury will see a significant reduction in pain and a return to an active lifestyle.
What is an ACL Injury?
The ACL is one of four ligaments in the knee that provides stabilization. It is connected to the front of the shinbone and the bottom of the thighbone.
When a knee is locked and there is a sudden pivot or change in direction, ACL injuries are more likely to occur. If there is a direct blow to the knee, forcing the knee into an abnormal position, an ACL injury is also likely. Women are significantly more prone to have an ACL tear than men participating in the same sports, according to the Mayo Clinic.
ACL injury symptoms include:
- Discomfort when walking
- A loud “pop” sound at the time of injury
- Severe pain
- Inability to continue activity
- Knee swelling that usually worsens for hours
Consult your doctor if you believe you have an ACL injury or tear. They will likely run tests that may include X-rays, magnetic resonance imaging (MRI), or ultrasounds to determine if you have an ACL sprain or ACL tear.
Treatments for an ACL Injury
A torn ACL will not be able to heal without surgery. A surgeon at South Florida Orthopaedics & Sports Medicine may create a stability plan for patients who are less active or do not participate in high-demand activities that include running and jumping. Typically, this nonsurgical treatment will include physical therapy and bracing.For those who need surgery, the ACL ligament will be completely replaced by an orthopaedic surgeon. The ligament is replaced with a tendon, which then acts as a graft. The graft will mature over time and become a new, living ligament.
The first step in the surgery is creating small incisions over the front of the kneecap. The ligaments needed for the graft are then removed. The incision is closed and the remainder of the surgery is performed through small incisions on the side of the knee. From there, a fiber-optic viewing scope is used to assist the surgeon and guide the ACL graft into place.
While the knee is bent, the damaged ACL is cleared away. A pin is inserted and will act as a guide to reconstruct the ACL. Then, holes are drilled into the tibia (shinbone) and femur (thighbone). The graft is attached to the guide pin, which is pulled through the drilled holes and into place. Finally, fixation devices, such as screws, are used to secure the ends of the graft to the femur and tibia. The surgeon will flex the knee to test the new joint.
After ACL Repair Surgery
After ACL repair surgery, physical therapy and rehabilitation will be required. The rehabilitation and recovery process is difficult and time consuming, but is an integral part of reconstructing a healthy ACL. Physical therapy is the first step. Your therapist will focus on returning motion to the joint and muscles surrounding the ACL.
Following physical therapy, a strengthening program begins to gradually increase the stress the knee is capable of handling and improve range of motion. This process can range from four to six months to restore the patient’s knee to full strength.
Recovery times may vary based on the surgery and it may take up to nine months before a patient can return to activities such as jogging, tennis, golf.
According to the American Orthopaedic Society for Sports Medicine, in more than 90 percent of patients ACL surgery is successful and allows patients to return to sports and workplace activities without suffering from knee instability.