- 22 July 2019
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ACL Tear – Causes, Symptoms & Treatment
You would wonder in “awe!” to know that there are very minute parts in the human body, which does rather complex and prominent tasks, and one example of such parts is a ligament called Anterior Cruciate Ligament or ACL. Ligaments are a tight and strong band of fibrous tissues connecting thigh bone and shin bone.
ACL ligament helps to connect the thigh bone to the shin bone. ACL holds the thigh bone and shin bone together and also restricts excessive motion of the knee joint to prevent damage to the knee joint.
ACL tends to tear partially or entirely with activities as mentioned above. The tear could bring excruciating pain and reduction in the range of motion.
Since this condition is very common, we would like to share information about an ACL tear, causes, symptoms, and treatment options available at Sunshine Hospital, Bhubaneswar.
What is Anterior Cruciate Ligament, and What causes a Tear?
The main ligament that is ACL controls the movement of the shinbone (tibia) with the help of the thigh bone (femur).
Anterior Cruciate Ligament (ACL) is a strong fibrous tissue band on the knee which, prevent excessive forward tibial movements on the thigh bone.
ACL is one of two crossing bands that intersect in the middle of the knee, and the other is MCL or medial collateral ligament. Together, ACL and MCL stabilize the knee joint.
An ACL tear or sprain is one of the most common knee injuries in the anterior knee joint. ACL injuries are most common in sports involving sudden breaks or changes in direction, jumping and landing, such as soccer, basketball, football, and skiing. Many people hear or feel “POP” on their knees when the ACL is injured. The knee can swell, feel unstable, and become too painful to support the weight.
Causes Of ACL Tear:
The strong bands of tissue are ligaments that bind one bone to another. An ACL, one of two ligaments that intersects in the middle of the knee, and this ligament stabilizes the knee by connecting the femur to the tibia.
ACL tear often occurs when we put stress on the knee with exercise and sports activities that can affect the knee: Causes of the anterior cruciate ligament can be several ways:
- Rapidly Changing direction
- Sudden slow down while running
- Incorrectly landing while jumping
- Direct contact or collision
- Rotating suddenly with sturdy feet
Some studies show that females are more prone to ACL tear in comparison to their male counterparts. This is because, due to differences in physical condition, muscle strength, and neuromuscular control. Other possible causes include differences in the alignment of the pelvis and lower extremities, increased easing of ligaments, and estrogenic effects on ligament properties.
Symptoms Of ACL Tear:
If you injure the anterior ligament, you may hear a “POP” sound and may feel pain. Other typical symptoms are:
Pain due to swelling. Within 24 hours, your knees are swollen. Sometimes when ignored, swelling and pain may resolve on its own. However, if you try to exercise again, your knees tend to be unstable, and there is a risk of damaging the meniscus in the knee.
- Feeling of knee giving way/weakness/instability
- Hearing a “popping” noise
- Joint tenderness
- Swelling within 24 hours
- Pain or discomfort
- Loss of full range of motion
- Sudden instability
- Discomfortness while walking
- Physical Examination
- Patient Medical History
- Imaging Tests
- Magnetic resonance imaging (MRI) scan
Treatment Options For ACL Tear At Sunshine Hospital:
ACL tear treatment depends on the individual needs of the patient. For example, a young athlete who practices nimble sports will most likely need surgery for safely returning to the sport. Less active, usually older patients can return to a more relaxed lifestyle without surgery.
The treatment of ACL depends upon the severity of the tear, the procedure is done to restore your strength and stability, and that may include rest and rehabilitation exercises, or surgery to replace the damaged tendon, followed by rehabilitation. Appropriate training programs can help reduce the risk of ACL injuries.
The torn ACL does not heal without surgery. However, non-surgical treatment may be useful in elderly patients or patients with very low activity. If total knee stability is intact, your doctor can recommend simple options, without surgery.
Medications: Analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat ACL tear.
Bracing: To protect the knee from instability, your doctor can recommend a brace, and you may receive crutches to keep you from putting weight on your leg.
Physical therapy: Like swelling, is reducing start a careful recovery program. Special exercises restore knee function and strengthen the leg muscles that support it.
Rest: Complete rest is needed for treating and limits bearing weight
Ice: When you wake up, try to ice your knee at least every two hours for 20 minutes.
Compression: Wrap an elastic bandage or wrap compression around the knee.
Elevation: Keep your knees on the pillow for the support or to keep in position
The doctor will suggest you for knee surgery for the following:
- If above all nonsurgical treatment fails
- An athlete who wants to continue in the sport, especially if the sport involves pivoting or jumping.
- if meniscus or more than one ligament in the knee is injured
- The injury is causing the knee to pain during everyday activities
Usually, ACL tears are not treated or repaired with suture back together because the ligament must be reconstructed surgically to repair the ACL and restore knee stability. Sutured ligament ACLs generally don’t work as time goes on. Therefore, torn ACL is usually replaced by tissue graft made of tendon. This graft acts as a scaffold for newly grown tendons.
- Autograft used from the hamstring tendon
- An allograft is taken from a patellar muscle, Achilles tendon, semitendinosus, gracilis, or posterior tibialis tendon
- Autograft used from a patellar tendon
- Autograft used from the quadriceps tendon occasionally
It would help if you discussed the possibility of choosing a transplant with an orthopedic surgeon to determine which is best for you.
Because recovery takes time, it may take six months or more for athletes to be able to return to sports again after surgery.
Anterior cruciate ligament surgery is carried out with an arthroscope with a small incision. Arthroscopic surgery requires minimal invasive. The benefits of less invasive techniques include fewer surgical pains, fewer hospital stays, and faster recovery.
Regardless of whether you have had surgery or not, rehabilitation plays an important role in bringing you back to your daily activities. The physiotherapy program will help you regain knee strength and movement.
If you have surgery, the first physiotherapy focuses on the returning movement to the joints and muscles around it. This was followed by a strengthening program to protect the new band. This strengthening gradually increases stress in the band. The last phase of rehabilitation is aimed at functional returns that are suitable for athletes’ sports.
Of all the conditions associated with knee, Anterior Cruciate Ligament tear or ACL tear is the most common one. ACL is the most prominent of the ligaments associated with a knee. As discussed extensively, an ACL tear is quite common in athletes and those performing activities involving sudden jerking and stopping motions with the knee.
Taking medication, limiting movement with the knee, and wearing a brace/sling can help reduce the ACL condition, but if you wish to get back to your normal/active life, ACL tear needs to be operated upon. The operation can treat the ACL tear, but the most important part is where the knee is given adequate time to regain its strength. Soon after the ACL reconstructive surgery, patients can walk and bear weight on the knee without any difficulty.
They presume that the knee has successfully resuscitated, but that is completely wrong. After surgery to the ACL, limiting activities and resting the knee for a period of nine to twelve months is mandatory to make sure that the ligament has completely fused with both the bones.
Have further questions that need to be answered by our team of Orthopedic surgeons, please pick up your phone and call us at 0674 257 1188
About Sunshine Hospitals:
Sunshine Hospitals, Bhubaneswar is an ultramodern 125-bed, tertiary care hospital located in the heart of Bhubaneswar. Established in the year 2015 with a mission to provide quality healthcare services to the people of Odisha. Sunshine’s patient-first approach steers it steadily in the direction of ensuring that state-of-the-art technology meets state-of-the–heart services to produce positive patient outcomes.