A ligament is a dense connective tissue that connects bone to bone.
The knee joint is held tightly together by four ligaments: the inner and outer fan-shaped hinge ligaments (medial and lateral collateral ligaments) and the crossing (cruciate) ligaments, which sit in the middle of the joint (the anterior and posterior cruciate ligaments)
The anterior cruciate ligament (ACL) is an important stabilizing ligament in the knee. This ligament hold the two bones of the knee together . The anterior cruciate ligament (ACL) prevents forward and backward motion .
The ACL functions as a knee stabilizer. Without the ACL the knee becomes unstable and often “gives way”, especially with sports activities that include running, jogging, pivoting, and twisting.
The menisci are 2 cartilage “C” shaped disks in the knee. There is one on the inner portion (medial) and outer portion (lateral) of the knee. The meniscus works as a shock absorber in your knee. They are also seconday stabilizers of the knee.
The most common mechanisms of injury are rapid change of direction, planting of the foot with twisting of the knee, decelerating, landing from a jump, or a direct blow to the knee.
ACL injuries most commonly occur during sports, running , jogging, football. Car and bike Accidents , fall from bike may injure the ACL. Sometimes a simple slip and fall at home may also tear your ACL ligament.
You may will feel or hear a “pop” at the time of the injury. Most patients will have significant swelling in their knee within the first few hours after injury. Most patients are unable to continue participation in their activity after the injury. Some patients will sense that their knee is unstable or “wobbly” and they have difficulty even walking
Anterior cruciate ligament (ACL) injuries are treated with
Surgery and post-surgical rehabilitation ( Arthroscopy or key hole surgery)
Non-surgical rehabilitation program.
The decision to have surgery is based upon several factors, including your age, how active you are, and whether you have other knee injuries.
Physical therapy is great for helping to use your muscles to help stabilize your knee. Having strong and flexible quadriceps, hamstrings, and calf muscles will help to provide extra stability to the knee.
What is Non -Operative Treatment for ACL tear ?
Non operative treatment is reserved for ACL sprains and partial ACL tears. It involves medication and Physical therapy. Sometimes you may need and intraarticular PRP injection / plasma therapy in addition to the physical therapy for better healing of the ACL. But if the ACL is completely torn it will not heal with physical therapy alone and needs operative management.
If surgery is required, or you elect to undergo surgical fixation of your knee, a graft is used in place of your old ACL.It is a Arthroscopic surgery i.e. KEY HOLE surgery. Minimally invasive with faster recovery. Tunnels are drilled into your tibia (shin bone) and femur (thigh bone) and the new ACL is held securely by a fixation device. The torn ACL is removed and replaced with the graft . This surgery is done under a Spinal anaesthesia and takes approximately 60-90 minutes
Our patients are in a knee brace for 4-6 weeks after surgery. We utilize this brace to protect the graft until your muscles are strong enough to support your leg without risk of your knee buckling.
You can walk putting full weight on the operated leg within 24 hours of the surgery. As you bear full weight, it stimulates your muscles and helps to strengthen them. Most patients use crutches/walker support for 3-10 days.
You will start a physical therapy the next day in the hospital stay itself. You can put full weight on the knee and walk with the help of a crutch/walker support. Your physical therapy regimen/program will continue for 6-8 weeks which will by advised by our physiotherapists .
During the second 6 weeks of physical therapy you will begin more functional activities. Most patients begin running , sports activities at week 12.
