The Anterior Cruciate Ligament

The knee consists of 4 ligaments, 2 collateral ligaments, and the anterior and poster cruciate ligaments. The collateral ligaments are situated on the side of the knee, while the other 2 ligaments are inside the knee. The anterior cruciate ligament (ACL) extends from the femur to the tibia and prevents excessive forward movements of the tibia. An ACL tears occur as a result of sports injuries, motor vehicle accidents, and work injuries.

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What happens when the ACL is torn?

The rupture of ACL is classified into 3 grades. Grade 1 tear is a mild injury, and knee stability is preserved. Grade 2 is known as a partial tear due to a partial rupture of the ligament. Grade 3 is the complete rupture of the ligament with no knee stability. Most ACL tears are complete and partial tears are rare. A person with an ACL tear will experience different symptoms depending on the grade of the tear. Severe knee pain, swelling, and a loud pop in the knee are common. Other possible symptoms include loss of range of movements, inability to bear weight on the leg, and knee instability.

Repairing the torn ligament

Treating an ACL injury depends on the severity of the tear. Grade 1 tears are treated conservatively with rest, ice, compression, elevation, use of a brace, and physical therapy. The doctor usually recommends surgery in complete tears with no knee stability. The surgery performed is ACL reconstruction surgery, where a tendon graft is used to replace the torn ligament. After the operation, the doctor will prescribe pain medications such as non-steroidal inflammatory drugs (NSAIDs) and recommend physical therapy.

Caring for the repaired tear

After surgery, the surgical site is kept clean and dry and monitored for at least 2 weeks. Early mobility is also advised to strengthen the muscles. Ice is applied to the knee if necessary to lessen pain and swelling. Sometimes the doctor will use a post-operative brace or require the patient to use crutches.

The purpose of rehabilitation

Physical therapy is an important addition to the recovery process. This type of rehabilitation reduces knee swelling and restores the knee’s range of movement. Additionally, the involved muscles become stronger, and knee stability is maintained during physical therapy.

Risks with repair

Possible complications after surgery exist, but the risk is not the same for every patient. Risks include infection, bleeding, blood clot, numbness, knee pain, stiffness, and chronic instability. Because grafts are used in this surgery, there is a chance of transmitted viral infections and failed extensor mechanisms.

What is the outlook like?

With conservative treatment, the prognosis for partial tears is good, but close monitoring is needed for an unstable knee. For complete ACL rupture, surgery is usually required. Patients undergoing surgery can resume activities after 6 months to a year, but this varies from case to case. When considering treatment for an ACL tear, speak to the doctor about treatment options, risks, and outlook.

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