Anterior Cruciate Ligament Injuries
Jonathan Hersch, M.D. { Orthopaedic Associates USA }
Every year thousands of athletes tear their anterior cruciate ligament (ACL) in their knee. Ligaments are strong band like tissue that connects your bones together. In the knee there are two important ligaments that crisscross to give your knee stability. The ACL prevents the tibia (shinbone) from sliding forward beneath the femur (thighbone) and prevents abnormal rotation of the knee. The ACL can be injured in several ways including: 
changing direction rapidly, slowing down when running, landing from a jump and direct contact such as a tackle. Young people (age 15-25) who participate in sports that require pivoting (i.e. basketball and soccer) are especially vulnerable.
If you injure your ACL you may not feel immediate pain but may feel a pop in the knee. Usually within 2-12 hours, the knee with get very swollen and it may be difficult to stand. The first treatment is rest, ice, compression and elevation (RICE). A brace, if available can be placed to immobilize the knee. Crutches are useful to aid with ambulation. If a suspected ACL tear occurs you should consult an orthopaedic surgeon as soon as possible to evaluate your condition. Until you are evaluated by the physician, you should not continue playing sports because your knee may give out causing damage to the knee cartilage and /or meniscus.
A diagnosis of an ACL injury is based on a through physical examination of the knee. In addition your orthopaedist may order an x-ray and MRI to confirm the diagnosis. A complete tear of the ACL is a serious injury. Most of the time in young patients, especially athletes, an ACL reconstruction will be recommended. Less active people may be treated nonsurgically with a program of muscle strengthening and rehabilitation.
An ACL reconstruction replaces the damages tissue with a new strong piece of tissue from somewhere else in your body. Most commonly a strip of your kneecap tendon or hamstring may be used. Using an arthroscope as a guide, the tissue is passed through the knee and fixed in
place making a “new” ACL.
This surgery is done as an outpatient, no hospital stay is required. Only small incisions are made in this minimally invasive procedure.
Successful ACL reconstruction surgery stabilizes the loose knee and prevents further injury to the knee. After surgery, rehabilitation exercises will need to be performed to regain motion, flexibility and strength. On average a minimum of 6 months is required before returning to pivoting sports. However, simple walking is possible in a matter of days and most people can return to work or school within a couple of weeks. If you think you have torn your ACL or have suffered a severe knee injury, don’t want until more damage is done. Consult an orthpaedic surgeon to evaluate your knee.
