Whether it's the sound of an audible pop at the time of injury or the subsequent pain and swelling that follow, an ACL (anterior cruciate ligament) injury can bring life to a temporary standstill. However, orthopedic medicine has paved the way for a range of treatment options beyond waiting for time to heal. From structured nonsurgical approaches to comprehensive surgical interventions, the path to recovery has never been more promising. Let the team at Northwest Extremity Specialists help you choose a treatment plan that best fits your unique needs.
About ACL Injuries
An ACL injury is a common knee injury that affects the ligament connecting the femur (thigh bone) to the tibia (shin bone) at the front of the knee joint. The ACL stabilizes the knee and controls its forward and rotational movements.
Injuries to the ACL often occur during sports activities that involve sudden changes in direction, pivoting, or direct impact to the knee, such as soccer, basketball, skiing, and football. Females are more prone to ACL injuries due to differences in anatomy, hormonal factors, and biomechanics. However, a history of ACL injury in one knee can increase the risk of injury to the other knee.
Diagnosing an ACL Injury
Diagnosing an ACL injury typically involves a combination of physical examination, medical history review, and imaging tests like MRI scans. Symptoms of an ACL injury include:
- Audible pop
- Severe pain
- Bruising
- Swelling
- Knee stiffness
- Limited range of motion
- Instability
- Difficulty walking
- Reduced strength
- Difficulty standing on one leg
- Difficulty participating in activities
Treating ACL Injuries
When it comes to treating an ACL injury, there are two primary options nonsurgical or surgical treatment. The choice between these options depends on various factors, including your age, activity level, the extent of injury, and personal preferences.
Nonsurgical Treatment
For individuals diagnosed with partial ACL tears or those with relatively low-impact activity levels, physical therapy strengthens the muscles and aids in stabilizing the knee, compensating for the ACL's diminished function while promoting overall joint integrity. The carefully calibrated exercises also help restore flexibility, thereby facilitating a more natural range of motion over time.
The duration of physical therapy recommended for treating an ACL injury can vary widely depending on the severity of the injury, the individual's overall health and fitness, the specific treatment plan, and how well the individual responds to therapy. Generally, the recovery and rehabilitation process for an ACL injury can take three to six months, with six to nine months of physical therapy recommended for more active individuals.
In addition to physical therapy, a knee brace may be recommended to provide external support to the knee joint. This assists in preventing excessive movements that could exacerbate the injury and supports the gradual recovery process.
Surgical Treatment
Surgical intervention is frequently advised for athletes and individuals diagnosed with complete ACL tears, particularly those who actively participate in high-demand sports or experience considerable knee instability. ACL reconstruction involves the replacement of the torn ACL with a graft, often sourced from the patient's patellar tendon, hamstring tendon, or, in some cases, a donor tendon. This graft serves as the foundation for the new ligament to develop over time.
The surgery itself is commonly conducted using an arthroscopic technique, wherein small incisions are made around the knee joint to introduce specialized instruments and a tiny camera called an arthroscope. This minimally invasive approach allows surgeons to visualize the internal structures of the knee on a screen, facilitating precise and controlled maneuvering during the procedure. The arthroscope guides the surgeon's movements as they prepare the graft, create tunnels within the bones to accommodate the graft, and secure it in place using screws or other fixation devices.
The benefits of ACL reconstruction surgery include restoring knee stability, reducing the risk of further damage to other knee structures, and potentially allowing you to return to your pre-injury activity levels. However, it's important to note that while surgery can provide a strong foundation for recovery, successful outcomes heavily rely on postoperative rehabilitation. You must commit to a structured physical therapy program, which gradually restores knee strength, range of motion, and stability, ensuring the new ligament graft integrates effectively within the joint.