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Anterior Cruciate Ligament Injuries (ACL Injuries)

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

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
  1. Feeling of POP sensation after a fall
  2. Instability of knee joint
  3. 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 Drawer’s test and Lach man’s test.

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 using
    autologous grafts. The most common grafts used area are hamstrings, Quadriceps and
    BTB (patella tendon) grafts.

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 & patient usually returns to sports activities after a period of 9-12 months.

Dr. Anil Raheja (Orthopedic)

  • Alumnus of M.D.U. University Rohtak
  • Member of Medical Council of India, Indian Orthopedic Association, Indian Society of Hip & Knee Surgeons, Indian Medical Association and Delhi Medical Association
  • More than 20 decades of Experiences
  • 18,000 + procedure performed till date
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