Anterior Cruciate Ligament Injuries (ACL Injuries)

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Anterior Cruciate Ligament Injuries (ACL
Injuries)
www.orthodelhi.com
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In the human body, knee is one of the largest
joint of the body including the thigh bone
(Femur) articulates with leg bone (tibia) and
there is another bone in front called as knee cap
(Patella). The joint is stabilized by major
ligaments, two collateral ligaments on inside and
outside the knee joint. Two cruciate ligaments
running criss cross from anterior to posterior
(ACL) and posterior to anterior (PCL). ACL is
the main restraint to anterior translation of the
tibia in relation to femur. It is one of the
commonest ligaments to be injured in sports
particularly.
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Causes of Anterior Cruciate Ligament (ACL)
Injuries It can be injured in isolation or can
be associated with collateral ligaments or
meniscus Injury depending upon the force or
mechanism of injury. Main symptom of Anterior
Cruciate Ligament tear Feeling     of POP
sensation after a fall Instability     of knee
joint Give     way feeling of knee and locking of
knee joint if associated with a     meniscal
tear. On examination there is effusion of knee
joint instability as demonstrated by Drawers
test and Lach mans test.
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Diagnosis is confirmed with MRI which tells about
the extent injury. The extent of injury helps us
to formulate strategy regarding the correct line
of treatment. A standing X-ray of lower limb
tells us about the overall alignment of the knee
joint. Treatment for Anterior Cruciate Ligament
(ACL Injuries) 1. Initial treatment includes Ice
Packs and immobilization in knee brace for 2-3  
  weeks. Unfortunately ACL injury does not heal
itself. This requires surgical     treatment in
symptomatic patients. Untreated ACL ligament
injuries will     lead to early onset of
osteoarthritis of the knee joint. 2. The
standard treatment of ACL injury is Arthroscopic
ACL reconstruction usingautologous grafts. The
most common grafts used area are hamstrings,
Quadriceps and BTB (patella tendon) grafts.
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For Arthroscopic reconstruction the patient is
admitted in the hospital on the day of surgery
itself. Some routine blood investigation, ECG
etc. are performed. After preparation patient is
taken up for surgery on the same day. Typically
the surgery lasts for around one
hour. Rehabilitation of Anterior Cruciate
Ligament 1. After surgery patient starts
rehabilitation under the guidance of expert
physiotherapist on the same evening. 2. Next    
day the patient is allowed to walk with the help
of crutches or walker. 3. The     rehabilitation
continues for a period of 4-6 weeks. 4. Patient  
  can drive after 6 weeks. 5. The     work load
on the knee is gradually increased amp patient
usually     returns to sports activities after a
period of 9-12 months.
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