There are four ligaments in the knee, the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) and the lateral collateral ligament (LCL). The ligaments are responsible for allowing the knee to have normal range of motion as related to the rest of the leg. The ACL which is located in the center of the knee controls rotation and forward movement of the shin bone.
The Most Common Knee Injury
The ACL is one of the most commonly injured parts of the knee, with over 100,000 tears reported annually in the United States alone. When the knee rotates inward, additional strain is placed on the ACL as the two bones forming the knee joint move in opposite directions. This causes the ACL to tear. In cases of an ACL injury, surgical treatment is often required. This is a common injury among athletes such as football, basketball, and soccer players.
Stressful movements for an ACL
The majority of ACL injuries occur during sports that can put stress on the knee. Some of the most common movements as follows:
- Suddenly slowing down and changing direction (cutting)
- Pivoting with the foot firmly planted
- Landing from a jump incorrectly
- Stopping abruptly
- Receiving a direct blow to the knee or collision, such as a football tackle
A reported 51 NFL players tore their ACL during the 2017 season, with the majority occurring before Week One.
Arthroscopy treatment of ACL repair
Especially in the case of a severely torn or ruptured ACL, the ligament must be removed and replaced with other tissue. The two most common sources for this replacement tissue are the patellar ligament and the hamstrings tendon. These can be found within the same patient or may come from a donor. The surgical procedure is arthroscopic, meaning that a small cut is made for a camera to be inserted through. The camera can send video to a monitor so that the surgeon can see the damage and determine a course of action.
In the case of donated tissue, the surgeon only needs to drill a hole so that the new ACL can be guided in. Once that graft is pulled through, two screws are placed into these holes in the bones for security. When using tissue from the patient, the surgeon may need to make a wider incision in order to retrieve the graft to be used. Recovery time from this surgery often takes between one to two years or longer. Part of this depends on whether the patient used their own tissue or a donated graft.
Alternate therapy for ACL injuries
If the ACL is not severely damaged, there are some non-operative treatment methods to improve the patient’s condition. These treatments involve strengthening muscles around the knee, such as in focused physical therapy guided by a physician or physiatrist, cryotherapy, and regenerative medicine.
When is the best time for ACL repair?
Many individuals avoid having a knee injury examined assuming if they can walk, it’s ok. This can be a dangerous assumption, as a minor twist or hit to the knee can cause serious damage. People who suspect they have injured their knee even in a minor fashion are encouraged to consult a doctor to avoid worsening their condition.
If you believe you may benefit from arthroscopy surgery, contact us to get a consultation with one of our orthopedic surgeons.