Anterior Cruciate Ligament Tear

Introduction to anterior cruciate ligament tear

The anterior cruciate ligament (ACL) is a ligament present in the middle of the knee that serves to keep the shin bone from sliding out in front of the thigh bone. A ligament is a band that connects two bones or two cartilages together. The anterior cruciate ligament keeps the knee stable, so it can swell and also be painful when a partial or total tear happens to it. Injury to the anterior cruciate ligament is seen commonly in sportsmen and women such as those who play basketball and football because they tend to suddenly move or jump in order to avoid other athletes during a gaming episode. When a torn ACL is ignored, further complications may arise.

Anterior cruciate ligament tear
Photo Credit: WebMD

Causes of an anterior cruciate ligament tear

Those with ACL tears are mostly highly active people. The tears are typically sport-related – football, soccer, basketball, and skiing. These sports involve jumping or swirling. Examples of movements that can cause an ACL tear include:

  • Jumping and landing flat-footed
  • Overstretching the knee joint
  • Abruptly changing direction
  • Using a different speed while running

A car accident or football tackle where the knee is hit can also cause an ACL tear. The gender prevalence of anterior cruciate ligament injuries is 2-10:1 with a higher prevalence occurring in females.

Symptoms of an anterior cruciate ligament tear

As soon as an anterior cruciate ligament tear occurs, a popping sound would be heard. Inflammation usually occurs within six hours following the injury with swelling and severe pains manifesting. Any movement such as walking, twisting or turning can further worsen the pains. The knee feels uncomfortable and shaky as if it’ll give way.

Diagnosis of an anterior cruciate ligament tear

An orthopedic surgeon is qualified to examine the knee. He asks about events leading to the injury, reviews past medical history and goes on to examine the lower limbs with special reference to the knee stability, power and the range of movement. The following tests may be ordered:

  • An X-ray of the knee: shows a bone fracture
  • Magnetic resonance imaging of the knee: it is the gold standard for diagnosis. Also shows soft tissue injury.
  • A Computed tomographic scan of the knee: shows small bone fractures

Treatment of anterior cruciate ligament tear

Treatment is dependent on the severity of the injury and the desired outcome. Some people may temporarily be okay following an ACL tear but it may pave way for other knee injuries to occur eventually. For an athlete who needs to speedily get back to work, surgery and physiotherapy are the best lines of treatment. For every case of an ACL tear, talk to your health care provider to be sure that there is no fracture or affectation of other ligaments. A blue knee is suggestive of an injured blood vessel so seek medical attention.

How is an anterior cruciate ligament tear conducted?

When an injury occurs, pain relievers are first given to cater for the pains e.g. Ibuprofen. Other times when surgery is recommended, surgical reconstruction can be done using a tendon from the knee cap or hamstring. A donor tissue can also be used for reconstruction. Before surgery occurs, speak to the doctor about the medications needed before and after surgery. Aspirin is usually avoided as it prevents blood from clotting.

Physiotherapy for a period of at least six months is vital to enable one to regain full range of movement on the leg and power.

Reconstructive surgeries usually have better outcomes, enabling one to go through less pain and earlier leg power and knee stability.  Arthritis is a likely eventual occurrence. One may not be fully able to return to sports without intervention.

Prevention of an anterior cruciate ligament tear

When one is strong, the risk of an ACL tear is reduced. Athletes should try to learn prophylactic methods for reducing pressure on the knees. Rather than landing flat-footed, try to land on the balls of the feet as this enables the calf muscles to support the body weight thereby reducing unnecessary pressure on the knees.

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