Football is an immensely popular high contact sport. Following on the heels of concussions and torn hamstrings, ACL injuries are next on the list. Recovery involves a quick outpatient reconstruction surgery followed by several months of physical therapy.
Why is the ACL useful?
Part of a duo connecting the tibia to the femur, the ACL (known as the anterior cruciate ligament) helps to stabilize the knee joint. The ACL is essential for normal dynamic knee movement and prevents excessive sideways bending or hyperextension.
How does the ACL differ from the PCL?
There are no major differences, and both perform essentially the same task of knee stabilization. The only major difference is that the ACL is often injured by sudden changes in direction or being hit from the side, while the PCL is often injured by a direct hit right below the knee cap or falling onto a bent knee. PCL injuries occur at a far lower rate than ACL injuries
Not all ACL injuries require surgery as physical therapy can be very effective. Surgery is recommended in situations when the patient is young, an athlete who wants to continue the sport, the knee can no longer continually bear weight or the ligament/cartilage is too severely damaged.
Before ACL Reconstruction, the patient will generally undergo weeks of physical therapy to strengthen the surrounding muscles and reduce swelling. The goal is to regain as much movement in the knee as possible prior to surgery.
During ACL reconstruction, the patient is put under general anesthesia. Small incisions are made on/around the knee and the surgeon will use a small surgical video camera and medical tools to perform the operation. The damaged ligament is removed and replaced with a portion of the tendon (also known as a graft). The graft is accurately placed between the femur and tibia, then attached with screws. The new ligament will grow on the graft.
After ACL Reconstruction, the patient is given a knee brace, taught how to walk on crutches, and instructions on how to shower as well as care for the wound. The general rule of thumb for post-surgery care is the RICE method: Rest, Ice, Compression, Elevation. Rigorous physical therapy is also recommended to regain as must strength and range of motion to the injured knee.
Typically caused by a sudden direction change or jarring motion, as is often found in football, ACL tears are painful and many require outpatient surgery. The incisions are small and patients are provided with a brace, crutches, and instructions for post-surgery care. Most athletes who adhere to the recovery plan set by their doctors can return to sports within the year.