Items Tagged With Anterior Cruciate Ligament

Anterior cruciate ligament (ACL) injuries are caused when the knee is straightened beyond its normal limits (hyperextended), twisted, or bent side to side.

Typical situations that can lead to ACL injuries include:

• Changing direction quickly or cutting around an obstacle or another player with one foot solidly planted on the ground (as can happen in sports that put high demand on the ACL such as basketball, football, soccer, hockey, and gymnastics).
• Landing after a jump with a sudden slowing down, especially if the leg is straight (such as in basketball).
• Falling off a ladder, stepping off a curb, jumping from a moderate or extreme height, stepping into a hole, or missing a step when walking down a staircase. Injuries from these situations tend to be caused by stopping suddenly, with the leg straight.

Inactive people and some older adults who have weak leg muscles may injure their knees during normal daily activities. However, they usually injure bones, not ligaments.

When contact causes an ACL injury, it can be from playing a sport, from a sudden and severe accident, or from less obvious contact injuries. In football, receiving a clipping contact injury-in which the bent knee is struck from the outside-can cause an ACL injury. Clipping often damages several knee structures at once, including the ACL, the medial collateral ligament (MCL), and the pads in the knee (menisci) that protect and cushion the joint surface and bone ends. Clipping injures the medial meniscus more often than the lateral meniscus.

An ACL injury may develop into long-lasting and recurrent (chronic) ACL deficiency that leads to an unstable knee-the knee buckles or gives out, sometimes with pain and swelling. This can occur if your ACL has not been treated or has been treated unsuccessfully, or if you had an ACL injury in the past and did not know it.

ACL  ACL Causes  Anterior Cruciate Ligament 

There are three main treatment goals. The first goal is to stabilize the knee if it is unstable-or at least stabilize it enough to suit your lifestyle. The second goal is to return your knee to normal or almost normal functioning. The third goal is to reduce the likelihood of further damage to the knee. Treating ACL injuries may also help to reduce pain, prevent osteoarthritis, and prevent loss of strength and decreased movement in the knee.

Initial treatment of an acute ACL injury consists of using first aid steps to stabilize your knee and reduce swelling and pain.

Later treatment may include several months of rehabilitation or surgery with rehabilitation. Not all ACL tears require surgery. Further treatment is nearly always a decision you and your health professional make between rehabilitation only and surgery plus rehabilitation.

Acute (sudden) ACL injuries

If you know you have injured your ACL, initial treatment consists of:

• First aid steps to reduce swelling and pain. This may include resting the knee, applying ice, using gentle compression with an elastic bandage, elevating the leg, and taking nonsteroidal anti-inflammatory drugs (NSAIDs).
• Using crutches and/or immobilizing splints in the first few days after an injury. If crutches or splints are used for too long, the muscles will become weaker from too little activity, and movement of the knee will become stiff and restricted.
• Strength and motion exercises to help prepare you for treatment. For more information, see:

  Pretreatment exercises for an ACL injury.

For information on specific first aid steps to take immediately after the injury, see the Home Treatment section of this topic.

Further treatment

After initial treatment for an acute ACL injury, further treatment of the injury depends on:

• How much of your ACL is torn (whether it is a grade I, II, or III sprain).
• When the injury occurred and how stable your knee is.
• Whether other parts of the knee are injured. If other parts of your knee are injured, it will be harder for the strong parts of your knee to compensate and protect the injured parts.
• Preexisting conditions of the knee, such as prior injuries that resulted in long-term (chronic) ACL deficiency, or osteoarthritis.
• How active you are.
• Your age and overall health status.
• Your willingness and ability to complete a long and rigorous rehabilitation.

Treatment options include:

• Nonsurgical treatment only, such as a physical rehabilitation program.
• ACL surgery to reconstruct the ACL or to reconstruct the ACL and repair injuries that occurred at the same time, such as a meniscus tear. Most ACL surgery is done by making small incisions in the knee and inserting instruments for surgery through these incisions (arthroscopic surgery). Open surgery (cutting a larger incision in the knee) is sometimes required. Physical rehabilitation always follows surgery.

For more information, see:

Should I have surgery for an ACL injury?

 

 

 

 

Prev - Next >>