The anterior cruciate ligament (ACL) is one of the four main ligaments in the knee, connecting the femur to the tibia. It is the most commonly injured ligament in the knee, with most injuries occurring as a result of sharp turns or sudden movements in sports. As the ACL is essential for maintaining balance and stability, it is crucial to ensure that any injuries are properly treated, particularly if you play sports.
There are three grades to ACL injuries. Grade 1 amounts to little more than a sprain, and a bit of rest and ice should be enough to get things back to normal within a month or two. A grade 2 injury is a partial tear of the ligament, and the rarest of the three grades. With partial tears, it can be difficult to assess whether surgical or non-surgical treatment is the best option. However, non-surgical treatment generally has less chance of long-term success, so surgery should always be given serious consideration. A grade 3 tear is a complete tear (or rupture) of the ligament, with surgery usually being the only treatment option available.
As stated above, most ACL injuries occur as a result of sudden movement, such as jumping or twisting the knee. A person who injures their ACL will immediately feel pain and instability. In the hours following the injury, the knee will swell considerably, lose its full range of motion, and continue to feel unstable and tender.
If you believe you have injured your ACL, you should visit your doctor immediately. To evaluate the situation, they may order x-rays or an MRI scan, as well as performing a physical examination known as the Lachman test. These tests will determine whether or not surgery is the best option.
Most ACL surgeries are arthroscopic, commonly known as keyhole surgeries, meaning they are done on an outpatient basis, and do not require an overnight stay. But ACL surgery does not usually just sew up the tear in the existing ligament, as this has proven to be an ineffective long-term solution. Intead, a graft is usually taken from a tendon elsewhere in the body, such as the hamstring. Recovery time after surgery is typically between 4 & 6 months, with the patient performing regular stretches to strengthen and restabilise the area. If the surgical option is not pursued, the injury will be treated through physical therapy, and possibly the use of a sports brace to protect the area.
Regardless of whether the surgical option is chosen or not, physical therapy is crucial to recovering from an ACL injury. Although 81% of people can return to sports after an ACL injury, only 55% of them return to their previous levels. This is largely due to inadequate rehabilitation, so if you have suffered an ACL injury, be sure to understand and commit to the correct exercises, as failure to do so will greatly reduce your chances of making a full recovery.