Anterior Cruciate Ligament Rupture
Role of ACL
One of four major ligaments in the knee.
Connects femur (thigh bone) to tibia (shin bone).
ACL prevents your tibia from going too far forward or rotating too much. In addition to being a mechanical stabiliser, it also provides input to your nervous system about joint position.
Risk factors for injury:
- Female sex (4 to 6 times higher risk than males)
- Increased anterior-posterior knee laxity
- Previously torn ACL
- Cutting, pivoting and single-leg landings
Key signs of injury:
- Feeling a “pop” at the time of injury
- Immediate swelling after the injury
- Deep pain in the knee
- Instability: the knee feels like it is “giving out”
ACL Reconstruction Surgery:
The decision to have ACL surgery depends on many factors, including the patient’s age, activity level, and other injuries. In the case of surgery, the surgeon will remove the torn anterior cruciate ligament and create a new one using a graft. A variety of ACL grafts can be utilised including:
Patellar tendon. A patellar tendon autograft utilises the patient’s own tendon to replace the torn ACL, and is beneficial because of its inherent rapid healing.
Hamstring tendon. Autografts using the patient’s hamstring have become increasingly more common because they are not associated with anterior knee pain.
Cadaver tendon. Allografts, which are the utilization of cadaver tendons, are preferred by some surgeons because they do not require removal of the patient’s own tendon.
Physiotherapy for ACL rehabilitation:
The major goals of rehabilitation of the ACL-injured knee:
- Gain good functional stability
- Repair muscle strength
- Reach the best possible functional level
- Decrease the risk for re-injury
Your best way to avoid ACL reconstructive surgery is to undertake a comprehensive ACL-Deficient Knee Rehabilitation Program that involves leg strengthening, proprioception and high-level balance retraining, plus sport-specific agility and functional enhancement.
Learn more online at www.studioxphys.com.au
References:
Kubas, C. (2018). ACL Reconstruction Surgery: Prehabilitation // Gastown Physio & Pilates | Vancouver BC | Physical Therapy, Pilates, Acupuncture, IMS, Kinesiology, Massage Therapy, Naturopathic Medicine. [online] Gastownphysiopilates.com. Available at: https://gastownphysiopilates.com/acl-prehab/ [Accessed 12 Jun. 2018].
Michael Khadavi, M. (2018). ACL Tear Symptoms. [online] Sports-health. Available at: https://www.sports-health.com/sports-injuries/knee-injuries/acl-tear-symptoms [Accessed 12 Jun. 2018].
Patchwork & Pebbles. (2018). ACL Surgery | Rock Climber’s Guide | Start Here. [online] Available at: https://www.patchworkandpebbles.com/acl/ [Accessed 12 Jun. 2018].
Smith, H., Vacek, P., Johnson, R., Slauterbeck, J., Hashemi, J., Shultz, S. and Beynnon, B. (2011). Risk Factors for Anterior Cruciate Ligament Injury. Sports Health: A Multidisciplinary Approach, 4(1), pp.69-78.
(2018). ACL Surgery Rehab – Pt 4: Single leg + change direction | Feat. Tim Keeley | No.100 | Physio REHAB. [online] Available at: https://www.youtube.com/watch?v=kkeL0_7tPpM [Accessed 12 Jun. 2018].