Anterior Cruciate Ligament (ACL) Tears


Ligaments are tough bands of connective tissues that connect one bone to another. The anterior cruciate ligament (ACL) is located in the center of the knee and extends diagonally from the end of the thigh bone (femur) down to the shinbone (tibia). The ACL is responsible for stabilizing the shinbone so that it has a full range of movement, and is made up of two bundles of tissues which crisscross inside the knee, namely the anteromedial and posterolateral bundles. The two bundles work together to allow the knee and the shinbone to move in a range of directions.

Symptoms of Anterior Cruciate Ligament (ACL) Tears

ACL tears normally occur when a person suddenly changes direction or turns heavily on the knee, such as when playing football, when landing from a basketball jump, or from falling down when skiing. Common symptoms of a torn ACL are as follows:

  • A sensation of having something irritating the shin from the inside.
  • Inability to use the knee at the time of injury.
  • A sudden swelling of the knee, or a swelling of the knee within a few hours of injuring it.
  • Symptoms of severe pain that prevent you from performing other activities.

Patients who suffer a torn ACL require treatment to prevent further damage to the knee and reduce the risk of subsequent knee injuries. Generally, treatment options for an ACL tear are divided into surgical and non-surgical forms of treatment.

  • Non-surgical treatment, which is the first stage of treatment for an ACL tear, uses the RICE technique combined with medication, as described below:
    • R = rest
    •  I = ice
    • C = compression
    • E = elevation

Patients should use this method in order to train the joints and muscles around the knee so that it can move as before, and should exercise using range-of-motion techniques to strengthen the knee as quickly as possible, with the aim of returning the knee to its normal functioning. When the patient's symptoms have improved and the injured knee has increased in strength, the doctor will examine the knee again to assess whether the patient can perform certain physical activities, and at what level of intensity. If the patient is still unable to use his or her knee as before, then the patient must reduce his or her level of physical activity. If the knee does not recover naturally using this method, then the patient may need to undergo reconstructive surgery.

  • Reconstructive surgery is commonly used for the treatment of ACL tears. This type of surgery aims to prevent the shinbone from moving too far forward and return the knee to its normal functioning, thus preventing further damage to surrounding cartilage. During reconstructive ACL surgery, the doctor will remove what remains of the torn ligament and install a replacement.

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