ANTERIOR CRUCIATE LIGAMENT (ACL) TEAR IS ONE OF THE MOST COMMON KNEE INJURIES OF THE KNEE AND ACCOUNTS FOR THE MOST COMMON SURGERY DONE IN THE KNEE IN THE UNITED STATES.
ACL IA A STRONG LIGAMENT IN THE ANTERIOR PART OF THE KNEE AND OFFERS STABILITY TO THE KNEE AND HENCE THE SMOOTH MOVEMENT OF THE KNEE. IT IS DAMAGED DURING INJURIES IN SPORTSMEN AND IN INDIA THE MOST COMMON CAUSE OF ACL INJURY ARE BIKE ACCIDENTS. TWISTING OF THE KNEE COULD LEAD TO AN ACL TEAR.
PATIENT WILL HAVE KNEE SWELLING AND PAIN INITIALLY WHICH WILL SUBSIDE OVER A FEW DAYS AND ONE CAN START WALKING NORMALLY IN A WEEKS TIME EVEN WITH A TORN ACL. BUT THE KNEE MAY REMAIN UNSTABLE AND MAY BUCKLE OR GIVE WAY WHILE GETTING DOWNSTAIRS, RUNNING, SQUATTING ETC.
ACL TEAR CAN EASILY BE DIAGNOSED BY CLINICAL EXAMINATION AND MRI
THIS INSTABILITY CAN LEAD TO EARLY WEAR AND TEAR OF THE KNEE AND ALSO SUBSEQUENT MENISCAL TEARS AND CARTILAGE DAMAGE. AND THUS IF NEGLECTED OVER A PERIOD OF TIME THE KNEE WOULD BECOME PAINFUL AND OSTEOARTHRITIS MAY SET IN.
HENCE ACL NEEDS TO BE TREATED.
IN AN ISOLATED ACL TEAR IN PERSON WHO IS NOT A SPORTSMAN ACL REHAB EXERCISES ARE INITIATED AND THE PROGRESS MONITORED. IF DESPITE THE REHAB PATIENT TENDS TO HAVE SYMPTOMS OF INSTABILITY OR IF THERE IS AN ASSOCIATED MENISCAL TEAR ACL RECONSTRUCTION SURGERY IS ADVISED.
IT CAN EASILY BE RECONSTRUCTED WITH AN ARTHROSCOPIC SURGERY (KEYHOLE SURGERY). AND THIS WILL GIVE A STABLE KNEE AND PATIENT CAN EVEN GET BACK TO SPORTS AND CAN HAVE A NORMAL KNEE AND THUS CAN PREVENT EARLY OSTEOARTHRITIS.
TO RECONSTRUCT THE ACL HAMSTRING TENDONS ARE THE MOST COMMON GRAFTS TO BE USED. OTHER GRAFTS WHICH CAN BE USED ARE PATELLAR TENDON, QUADRICEPS TENDONS AND SOMETIMES ALLOGRAFTS.
SURGERY IS A MINIMALLY INVASIVE KEYHOLE SURGERY IN WHICH THE TENDON IF GRAFTED IN THE KNEE IN PLACE OF THE ACTUAL ACL AND IS HELD BY IMPLANTS LIKE BIO SCREWS (DISSOLVABLE SCREWS), ENDOBUTTON, TIGHTROPE ECT.
PATIENT CAN WALK FROM THE NEXT DAY OF SURGERY AND HAS TO DO EXERCISES AND CAN BE BACK TO NORMAL LIFE INCLUDING SPORTING ACTIVITIES AFTER AN ACL RECONSTRUCTION SURGERY.