An ACL injury is a tear or sprain of the anterior cruciate ligament (ACL) — one of the major ligaments in your knee.
ACL injuries most commonly occur during sports that involve sudden stops or changes in direction, jumping and landing — basketball, football and downhill skiing.In our country it is mostly occurs due to bike slip or road traffic accident.
Mostly people hear or feel a “pop” in the knee when an ACL injury occurs. Your knee may swell, feel unstable(like your knee is going to slip in one direction on weight bearing) and become too painful to bear weight.
Symptoms (what you feel)
- A loud “pop” or a “popping” sensation in the knee
- Severe pain and inability to bear weight
- Rapid swelling due knee filled with blood
- Loss of range of motion
- A feeling of instability or “giving way” with weight bearing
Physical examination (what doctor feel)
your doctor will check your knee for swelling and tenderness — comparing your injured knee to your normal knee. He may also move your knee into a variety of positions to assess range of motion and overall function of the joint and to do some specific test for various ligaments injuries.
Often the diagnosis can be made on the basis of the physical examination alone, but you may need investigations to rule out other causes and to determine the severity of the injury. These investigations may include:
- X-rays- X-rays may be needed to rule out a bone fracture. However, X-rays don’t show soft tissues, such as ligaments and tendons.but there may be some sign in the X-ray which can tell your doctor about ligaments injury
- Magnetic resonance imaging (MRI)- MRI can show the extent of an ACL injury and signs of damage to other tissues in the knee, including the cartilage, meniscus or other ligaments tear.
First-aid care can reduce pain and swelling to your knee. Follow the R.I.C.E. care at home:
- Rest. General rest is necessary for healing and limits weight bearing on your knee.
- Ice. When you’re awake, try to ice your knee at least three or four times a day 10 minutes at a time.
- Compression. Wrap a crape bandage around your knee.
- Elevation. put some pillow below knee while you lying down.
There is no need of plaster support in recent injury even plaster support can hamper early physiotherapy.if pain is intolerable then you can take anti-inflammatory and analgesic.
Nonsurgical treatment (Physiotherapy)
Treatment for an ACL injury begins from day 1 with 3 to 4 weeks of physiotherapy. A physical therapist will teach you how to do exercises that you will perform either with continued supervision or at home. You may also wear a knee brace to stabilize your knee and use crutches or walker for a while to avoid putting full weight on your knee.
The goal of physiotherapy is to reduce pain and swelling, restore your knee’s full range of motion, and strengthen muscles.
By training the muscles around the knee appropriately through exercise treatment, the body can learn to control the knee again, and despite extra movement inside the knee, the knee can feel strong and able to withstand force.
This course of physical therapy may successfully treat an ACL injury for individuals who are relatively inactive, engage in moderate exercise and recreational activities.
Arthroscopic ACL reconstruction (Surgery)
Your doctor may recommend surgery if:
- You’re an athlete and want to continue in your sport
- More than one ligament or the meniscus in your knee is also injured
- The injury is causing your knee to slip during day to day activities
- You wants to remain active in day to day life
During ACL reconstruction, surgery is done with help of arthroscope (This method is less invasive and is proven to result in less pain from surgery, less time in the hospital, and quicker recovery times than “open” surgery ) so the surgeon removes the damaged ligament and replaces it with a segment of tendon —called a graft.Your surgeon will use a piece of one or two tendon from another part of your knee or from ankle joint.
After surgery you’ll resume another course of physiotherapy. Successful ACL reconstruction paired with rigorous rehabilitation can usually restore stability and function to your knee.
There’s no set time frame for athletes to return to play. A longer recovery period may reduce the risk of reinjury.
In general, it takes as long as a year or more before athletes can safely return to play. Doctors and physical therapists will perform tests to gauge your knee’s stability, strength, function and readiness to return to sports activities at various intervals during your rehabilitation. It’s important to ensure that strength, stability and movement patterns are optimized before you return to your previous level of activities.
Best arthroscopic Acl reconstruction by Dr. anil sharma
Dr. Anil Sharma is best arthroscopic surgeon in Jaipur. He is very knowledgeable and very friendly. You can discuss your knee joint problem and he will describe your problem in detail then you can understand your problem and which is best treatment or one surgery suitable for you. Dr. anil Sharma also has very affordable ACL reconstruction surgery options for patient who need ACL reconstruction surgery but not very much affording and/or who don’t have cashless or reimbursement facility.
ACL surgery is technically demanding surgery and Dr. Anil Sharma is best knee surgeon in Jaipur and he has various options for paediatric ACL reconstruction and for adult ACL reconstruction surgery.
Paediatric patients- epiphyseal tunnel or transepiphyseal tunnel with both side cortical fixation
Adult patients- all inside ACL reconstruction, single bundle ACL reconstruction, double bundle ACL reconstruction
Want to know more about surgical procedure