ACL Injury(anterior cruciate ligament): Signs, Symptoms & Risk Factors

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ACL Injury(anterior cruciate ligament): Signs, Symptoms & Risk Factors

In this video SimpliHealth expert Orthopaedics Dr. Manpal Singh Narula will talk about ACL Injury(anterior cruciate ligament) and its Signs, Symptoms & Risk Factors. This ligament(ACL) is found in the knee and mostly gets injured during sports. According to our expert this injury occurs in sports like cricket, football, kabaddi, basketball, and other contact sports that require the player to move fast and twist and turn. 

ACL Injury Signs & Symptoms

Many patients tell me that they were just playing and suddenly turn to twist their knee with a popping sound. The patient may have swelling and pain in the knee for about a week. Then after that, the patient may start walking, even if the tear is not diagnosed. But they can feel the difference and lack of strength in their knees. They feel like the knee would displace itself and fall off, along with pain and swelling. 

These are the symptoms that the patient comes to us with. And after investigation, we trace back to the injury where they hurt their knee or fell. And that is causing pain, swelling, and instability. 

What is ACL(anterior cruciate ligament)?

We have certain ligaments in our knee joints. Some are on the inside and some on the outside. There are cross-shaped ligaments that provide stability to the knee, one on the back and one in front. The one in the front is the anterior cruciate ligament, and the one in the back is the posterior cruciate ligament. These ligaments go from one bone to the other. And are placed in a criss-cross fashion. And when there is a tear in the anterior cruciate ligament, we call it ACL injury. 

What are the risk factors of this ACL injury? 

An ACL injury can happen to anyone. However, sportsmen who play rough contact sports and the people who are overweight are at risk of getting this injury. 

But mostly,  people who play high-intensity sports are at high risk of ACL injury. When people come to us complaining about the limp in the knee and pain, we clinically examine them. In this clinical examination, we check for the stability of the knee. The ligament holds the knee in place, but the knee moves front and back instead of rotating without the ligament. Various diagnostic tests like the Lachman test, which check the pivot shift. We see if the knee is moving outwards. This is an acute injury. If the injury is a few days old, then we prescribe anti-inflammatory and provide a knee brace. 

These ligament injuries cannot be detected in an X-ray. It has to be clinically examined by a doctor, or it can be diagnosed with an MRI. Once the MRI has confirmed the tear, we have to determine whether it is a partial or complete tear. 

Partial ligament tear

If it is a partial tear, not very serious. We provide the patient with a knee brace. It is like a belt to keep the knee straight. We suggest the patient rest for 4-6 weeks. Followed by gradual physiotherapy rehabilitation and mild pain killers. A partial ACL injury and some other ligament tears heal very well with the knee brace and some anti-inflammatory. We suggest an initial period of rest and we give some cooling time of 3-weeks so that the other ligaments heal. 

Total ligament tear

If it is a total ligament tear then we suggest getting an ACL reconstruction. This ligament cannot be repaired. We have to make a new ligament inside the body. And this is called ACL reconstruction. And this minimal invasive procedure is done with a telescope called arthroscopy. It is a bloodless, painless surgery. The patient can start walking from the third day. Of course, there is a knee brace required. In 5-6 weeks, he’s walking normally, and by three months, he can resume normal sporting activity. So it is recommended to get a reconstruction surgery done for a total ligament tear. 

There could be a few complications if the knee is not treated. First, it will always be unstable. Second, the person can get arthritis sooner than expected. This is a very safe surgery. We take a ligament from the inside of the knee and fold it multiple times to give it strength. And then, we attach it to the original place of the ligament. There are new implants available now to fix this, which dissolve inside the body, they are called biodegradable screws. We can take this ligament from anywhere, like the round T ankle. We call this ACL reconstruction surgery. 

So we are making a new ligament from ligament from your own body. And the results are so satisfying. 

Like our expert said, professional players suffer from an ACL injury, and after this surgery, they can resume their professional game just after 3-6 months, which is a very demanding activity. So this is the extent of the success of this surgery. You can regain the normal strength of your knee. 

And he advises you not to ignore this injury at all. If it is a partial tear, then rest and rehabilitation are a must. And if it is a total tear then you should go for ACL reconstruction surgery, which is a very safe and predictable surgery. 

People who suffer from a partial ACL tear,  people who we suggest not to get the ACL surgery, people who are past 50-55 years, people who have a desk job, for them, exercise becomes a very important part of the treatment. 

When he says exercise, He means you should strengthen your quadriceps and hamstrings. So it is very important that you strengthen the muscle surrounding both the knee joints. This will reduce the work of the ACL. And the stronger we make the muscles with good exercise and good rehabilitation, the more helpful it will be to overcome the partial tear. 

Please do not ignore exercises whether you opt for surgery or not. Exercise before and after the surgery remains a very important part of your treatment. 

In the end, he would like to give you this message: stay safe, stay healthy, and do not ignore these sports injuries. Consult a specialist if you have these injuries because what you do in the early stage of the injury determines the quality of your life. 

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