Treatment of ACL Injuries

If you’ve ever experienced your knee buckling under you after a misstep, a fall, or a sports-related accident, you’re probably familiar with the concept of an ACL injury.  The Anterior Cruciate Ligament (or ACL for short) is a crucial ligament in the connections of the knee. It criss-crosses the front of the knee joint holding the Patella in place with both the Tibia and the Fibula.  Many athletes (both professional and weekend warriors) injure their ACL. It’s an unfortunately injury that nearly always requires surgery to reconnect the ligament to the other parts of the knee.

As with all injuries, the treatment of an ACL sprain varies from patient to patient. For those individuals who have injured their ligament in the course of sports or strenuous physical activities, they’ll most often require surgery so that they can return to their previous physical habits. For those individuals who are less active or lead a sedentary life, there may be non-surgical courses of action that will enable a return to that same less physical lifestyle.  Non-surgical treatments include bracing the knee to support the knee from instability resulting from a weakened or torn ligament; using crutches to avoid putting weight upon the knee with the hope of further protecting the knee from subsequent damage. In addition, non-surgical candidates may be recommended a physical therapy course in lieu of surgery. Specific exercises can help to strengthen the leg muscles that support the knee and will help to restore function.

A Grade 3 sprained ACL (or as it’s more commonly known, a torn ACL) will not heal without surgery.  And what’s more, simple sutures or stitches cannot repair an ACL tear. When a patient goes in for ACL surgery, the doctor will need to reconstruct the ligament. He or she will replace the torn ligament with a tissue graft  - or a guide that will encourage a new ligament to cross between the tear and reconnect to other muscles and bone. A tissue graft, like the one used in ACL surgery, involves moving a small piece of tissue (and in this case ligament) from one part of the body and planting it is another. In this case, grafts are often taken from the patellar tendon (which connects the patella to the shinbone), hamstring tendon, or the quadriceps tendon. There are advantages and disadvantages to each of these graft locations, and these options should be discussed with your doctor when you talk about your treatment options.

As with many surgeries, and especially surgeries that depend on the regrowth of muscles and tissue, a patient who receives ACL surgery must limit physical activity for six months or more after treatment. This waiting period gives the body a chance to heal itself and gives the ligament a chance to regrow along the tissue graft. During this waiting time, patients are often required to undergo a thorough physical activity program to help regain muscle strength and flexibility.

For more information on ACL injuries and treatment courses, please refer to http://orthoinfo.aaos.org/.

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