Anterior Cruciate Ligament Injuries-Treatments and Rate of Success

Introduction

The anterior cruciate ligament is an essential structure of the knee joint, playing a vital role in stabilizing and maintaining joint integrity and function. Torn ACLs are common in athletes and other sports persons who are involved in high-impact games. This article explores the causes, symptoms, diagnosis, and treatment of anterior cruciate ligament injury.

What Is the Anatomy of the Knee Joint?

The knee joint is a complex joint. It is a hinge joint that connects the femur (thigh bone) to tibia (shin bone) and also the smaller bones that run alongside the shin bone. The knee joint is the largest in the body and helps in supporting the weight of the body, doing movements, and stability. The key components of the knee joint are

• Bone Part:

  • Femur (Thigh Bone): It is the upper leg bone. It is the top part of the knee joint.

  • Tibia (Shin Bone): It is the lower leg bone and is located below the femur bone.

  • Fibula: It is a smaller bone that runs along the tibia and gives lateral support.

• Cartilages:

  • Articular Cartilage: The ends of three bones, namely the femur, patella, and tibia, are surrounded by a smooth substance called articular cartilage.

  • Meniscus: It is a C-shaped wedge located between the femur and tibia.

• Ligaments:

  • Anterior Cruciate Ligament: It is present at the center of the knee.

  • Posterior Cruciate Ligament: It is also present at the center of the knee.

  • Medial Collateral Ligament: It runs along the inner side of the knee.

  • Lateral Collateral Ligament: It runs along the outer side of the knee.

• Muscles: It contains two muscles namely hamstrings and quadriceps.

What Causes Anterior Cruciate Ligament Injury?

ACL injuries happen when there is a sudden restriction, direct blows to the knees, or a change in the direction of the knee. Some of the factors that torn ACL include

• Sports Activities: Torn ACLs are common in sports that need sudden stops, pivoting, and jumps. Some sports activities that have increased risk for anterior cruciate ligament injuries include basketball, football, skiing, tennis, and soccer.

• Collision: Activities like a direct blow to the knee may cause a torn ACL. This collision that causes ACL injury happens during sports or accidents.

• Incorrect Landing While Jumping: Poor or incorrect landing while jumping, particularly when the knee is extended, and the body weight is not distributed equally, may cause a torn ACL.

• Imbalance of Muscles: Weakness in the muscles around the knees, like hamstrings and quadriceps, may affect joint stability, and that, in turn, may cause injury to an anterior cruciate ligament.

In addition to this, many factors that cause anterior cruciate ligament injury include uneven playing surface, gender, age, and previous injuries. Usually, torn ACL often happens with other injuries in the adjacent ligaments, like tears in the medial cruciate ligament and the meniscus cartilage. Most torn ACLs occur in the middle of the ligament. These torn ACLs do not heal on their own.

What Is the First Aid for a Torn ACL?

The person should raise their leg above the heart level. Then, the person should apply ice on the knee and can take painkillers like Ibuprofen or some other non-steroidal anti-inflammatory drugs.

What Are the Symptoms of ACL Injury?

The symptoms of anterior cruciate ligament injury often vary in their intensity and depend on the extent of the injury. Some of the common symptoms include

• People often experience immediate pain after an injury that may vary from mild to severe.

• Knee swelling is a common symptom of anterior cruciate ligament injury that occurs within a few hours after injury.

• The person may feel instability of the knee. The knee may feel like it cannot support the weight of the body.

• The person may hear a pop sound at the time of injury. This may not be present in all cases.

• The person may experience difficulty in bending or straightening the knee. There will be a limited range of motion of the knee due to swelling and pain.

• The person may experience tenderness on touch over the ligament area.

• The person may experience discomfort and pain while performing weight-bearing activities like running, walking, and climbing stairs.

• The person may experience difficulty engaging in physical activities.

How Is Anterior Cruciate Ligament Injury Diagnosed?

The first step to diagnosing torn ACL is taking a proper clinical and personal history. Then, the specialist conducts a local physical examination of the affected areas, followed by medical imaging such as X-rays, magnetic resonance imaging (MRI) scans, and computed tomography (CT) scans to identify the location of the underlying pathology. The treatment plan is then devised accordingly. Arthroscopy is inserted into the knee joint through a small incision to visualize the ligaments and their structures. In addition to this, diagnosis involves the assessment of functional movements.

How Is Anterior Cruciate Ligament Injury Treated?

Treatment plans for torn ACL depend upon the extent of the damage to the joint and may warrant one of the following procedures:

• Torn ACL may be treated first with conservative treatments like rest and rehabilitation procedures.

• It can also be treated non-surgically using braces. Braces are used for stability and support of the knee joint during the healing process.

• Pain and inflammation in the joint can be managed by prescribing non-steroidal anti-inflammatory drugs.

• The surgical treatments for anterior cruciate ligament injury involve ACL reconstruction. Anterior cruciate ligament reconstruction is done by using arthroscopy. In the ACL reconstruction procedure, a torn ACL is replaced with a graft that is often taken from the patellar or hamstring tendon.

• After surgery, the person should be instructed to go for physical therapy. Bracing and other supportive measures should be taken postoperatively to achieve better recovery.

Conclusion

ACL reconstruction is considered a somewhat risk-free surgical procedure intended to eliminate knee pain, damaged tissue, and reconstruction of injured ligaments from repetitive strain and overuse. Recovery usually takes a few weeks with certain precautions, occupational therapy, and pain management. Care must be taken to prevent addiction to opioids prescribed for pain management. Reaching out to a specialized healthcare provider may be beneficial.