The anterior cruciate ligament (ACL) is one of the main knee ligaments. It helps to give steadiness to the joint during activities that involve twisting, turning or sidestepping.
It also provides important information to the muscles around the knee (proprioception) that provide the knee with protection during activities. The ACL runs from the back of the femur (thigh bone) to the front of the tibia (shin bone).
When the ACL is injured you can experience a popping sensation or sound, this is followed by immediate swelling due to bleeding into the knee (haemarthrosis).
Damage can occur during a non-contact twisting movement. Additional knee injuries can occur at the same time. These can include cartilage tears or damage to the joint surface.
When the ACL is torn the knee can feel like it is giving way, especially during twisting activities. If swelling happens alongside this then it is likely that damage is being done to the joint surface or meniscal cartilage. If this is not treated and the damage continues it can eventually lead to osteoarthritis.
Symptoms and diagnosis
Symptoms of an anterior cruciate ligament tear include feeling unstable or feeling that your knee gives way. This can be accompanied by swelling and pain. Usually patients will experience this when performing a twisting movement however a small number experience this when doing even simple activities.
A torn ACL can be difficult to diagnose. When the injury is fresh it can be too uncomfortable to perform an examination. Additional knee injuries at the same time can also make it difficult. If this is the case then an MRI scan will be needed to accurately diagnose the extent of the damage, a torn ACL cannot be seen with a simple x-ray.
As symptoms can sometimes only be felt when performing twisting activities problems from a torn ACL can worsen over time and put stress on other parts of the knee.
Late diagnosis of ACL injuries very common. Patients may try to return to their previous activities and sustain further damage to their knee. This can affect the result of reconstructive surgery.
There are different treatments for an ACL injury depending on your lifestyle.
If you have an active lifestyle, and wish to continue to have an active lifestyle including returning to high impact sports that involve rapid changes in direction then surgery to reconstruct the ligament is an option.
Patients with lower physical activity levels, or people, who do not participate in activities involving twisting, may find that completing a program of physiotherapy and rehabilitation will suffice. About one third of patients find that they are able to continue with their activities without major problems.
To treat an ACL injury without surgery you will need to undergo a supervised programme of physiotherapy. This will concentrate on these main areas:
To take the load off of your ACL the muscles around the knee must be strengthened, especially the hamstrings.
Balance and proprioception
The ACL tells your brain and muscles information about the position of your knee. To help compensate for the damage to the ACL other nerves must be retrained to perform this function.
A functional knee brace is sometimes prescribed to help patients with a damaged ACL.
Contact My Knee Doc for further information about ACL injury and to discuss your options.
Call 0161 4646399 today to arrange a consultation with Mr Gareth Stables.