ACL Tears
What is the ACL?
- ACL Stands for Anterior Cruciate Ligament
- The ACL is one of 4 Ligaments that help stabilize the knee
- Most used knee ligament
- Key Stabilizer of the knee- it guides the Tibia through a normal stable range of motion.
- ACL is a broad, thick cord the size of your index finger, with long collagen strands woven together in a way that allows it to withstand up to 500 lbs of force.
- ACL Injury
Most Commonly occur during sports that involve sudden stops, jumping, or change of direction.
- EX: Basketball, Soccer, Football, Tennis, Volleyball Gymnastics
- Many people will hear a "pop" when an ACL injury occurs
- Most Commonly injured ligament in the knee
- Two hundred thousand ACL injuries happen each year, and there are 100 thousand ACL reconstructions performed.
- Approx 50 percent of ACL injuries occur in combination with meniscus injuries or other ligaments.
- ACL Injury Causes
- Approx 70 percent of ACL injuries occur through non-contact mechanisms, and 30 percent come from direct contact with another player or object
- Females are more prone to ACL injuries
- ACL injuries usually occur during fitness activities that put stress on the knee
- Cutting/Slowing
- Change of direction
- Pivoting
- Landing Awkward from a jump
- Sudden Stop
- A direct blow to the knee
- Once you have an ACL tear, the risk of re-tear on a previously repaired ACL is approximately 15 percent higher
- Torn ACL Symptoms
- Popping sound at the time of injury
- Knee Swelling within 6 hours of the injury
- Pain- especially when you try to put weight on the injured leg
- Knee giving our or unstable
- ACL Tests
- The most commonly used test to determine if ACL has a tear
Lachman Test:
This test is to evaluate the abnormal forward movement of the Tibia.
- The knee is held slightly bent (20-30 degrees), and the femur is stabilized in one hand while shifting the Tibia in the other; this allows the doctor to feel for an ACL tear.
- Pivot Shift
- Are performed in the operating room with the patient under anesthesia. The Pivot Shift Test will test the knee joint's abnormal motion when the ACL tear is present.
- Drawer Test
- The Drawer Test happens with the knee at a 90-degree angle. You Shift the Tibia forward and back to assess for an intact ACL by pulling forward and an intact PCL by pushing back.
- Treatments
- If surgery is required, the ligament is not repaired but instead reconstructed.
- Usually, use a new ligament taken from the Patellar Tendon. Which is the Tendon that connects the quadriceps muscle to the Tibia or the Hamstring Tendon from the back of the knee or a donor
- Surgery is a recommended option for Patients with ACL injuries
- Surgery is usually delayed 3-4 weeks after an injury so the swelling and bleeding decrease
- Goals of ACL Surgery
- Restore as much stability as possible to the knee
- Restore the same level of function as pre-injury
- Limit the loss of operation of the knee
- Prevent injury to other parts of the knee
- Reduce Pain
- Rehab
- After surgery, follow what the doctor says for your rehab
- Most ACL surgery patients will start a rehab program that focuses on regaining range of motion and gradually bearing weight on the knee.
- The rehab process's primary goal is to gain full flexion and extension of the knee joint and build balance and strength.
- ACL First Aid for right after injury
- Rest the knee
- Put ice or Space Ice Knee Wrap on it
- Compression with the Space Ice Therapy Knee Wrap or any compression method
- Elevate- try to keep your leg above heart level.