jointsguruIf you are reading this article , it means you or your near one may have ACL ligament injury. You wanted to know more about ACL injuries.I will try to give you important facts based on my experience of 15 years.
You may be surprised to know that ACL injury is one of the most common sports injury and every year thousand of athletes had this injury during playing. It is also very common during road traffic accidents.
First I would tell you, what is ACL ? Our knee joint is made up of four ligaments. ACL, PCL,MCL and LCL. All these ligaments are needed for maintaining stability in knee joint. These four ligaments connect upper thigh bone to lower leg bones. Ligament are band like structure and help in smooth movements of knee joint.
ACL injury occurs when some one is running , playing or riding bike and than fall on his knee joint. There is sudden pop sound and person noticed that something wrong has happened to knee. There is immediately swelling in knee joint and there is difficulty in walking.
As patient visit a near by ortho dr and then get X rays done, x ray films are mostly normal. And dr usually ask him to take some rest and icing. some time a plaster or knee brace is applied.
After few days patient start walking again and then he feels that something is not right in the knee joint. He feels there is instablity and his balance is not proper. He may not be able to run or walk fast. If he tries to run then he may fall also. At that time he visit his dr again and now he is advised to go for MRi testing.
MRI is a advance test and it is little costly. It may cost between 4000 to 7000 INR depend on your city and lab quality. MRI can be of various types and at present 3 Tesla MRI is considered as gold standard. Once your MRI is done , your doctor can tell you whether you have a complete tear or partial tear. According to that further management planning is done .
if you are lucky and your MRI report suggest there is interstitial edema than in that case physiotherapy can help you. There is no need of surgery in interstitial edema or ACL strain.
ACL is like a cable made up of multiple thin wires. So if few fibres are torn then it is called partial tear. if all fibres are torn then it is called complete tear. If MRI is suggesting partial tear even then you might need surgery. Because partial tear may not heal by it self. If you are a person with very sedentary lift style like a chair job and age above 45 to 50 then some time surgery can be avoided in partial tear, but if you are younger guy and want to run and play then surgery is needed in partial tear too.
If there is complete ACL tear than surgery is only option. ACL ligament can not be repaired. So its surgery means that your doctor need to take some tendon from your body and make new ACL. It is not possible to repair your old ACL. There are many type of tissues in body which can be used as ACL graft. Most common graft which is used now a days is hamstrings graft. Hamstrings are group of muscles which are present in back of thigh and can be used to make your new ACL. Advantage of using hamstrings graft are many fold. if we remove ACL there is no harm in body and hamstrings can regrow. There is not need of a separate cut on body as it can be removed by same cut of ACL surgery.
apart from hamstrings other graft which can be used are bone patella tendon, peroneous or quadriceps graft. I would always recommend hamstring graft. if some time there is no good hamstring graft then peroneous can be used as other good option.
ACL surgery is done by one of the most advance technique in medical science. It is called arthroscopy. It requires very small cut and surgery is done with help of camera so doctor does not need to open your knee. With help of camera and specially designed instruments surgery is done. Hardly one to three stitches are needed.
Graft are fixed by bio screws and ends button in your bones. Bioscrews are specially made screws which have property of self dissolving so there is no metal in your bones and no need of second surgery to remove any screws.
After All surgery patient can start walking from next day. There is no need of bed rest. Cut is also very small so no pain or any big dressing is needed. Patient is advised to walk with walker support for 2 weeks and after that he can walk with out any support.
knee brace is given to support your knee that has to be worn for six weeks but you can remove it during rest.
stairs is allowed after 3 to 4 weeks. Jogging is allowed after 3 months. Sports can be started after 9 to 12 months.
if you do not get surgery at right time and delay it there is chances of meniscus or cartilage tear. So I would suggest you to go for ACL surgery and not delay it. Ideally first month of injury is best period but if you get your diagnosis late then you should not delayed it any further.
So it is about ACL tear and its management . if you have any questions feel free to ask me in comment section .
