The knee is stabilised by a group of muscles and four main ligaments. Two of the ligaments run along the inside and outside edges of the knee and are called the Medial and Lateral Collateral Ligaments respectively (MCL/LCL). The other two are known as the Posterior and Anterior Cruciate Ligaments (PCL/ACL) and are located inside the knee joint.
Tears in the Anterior Cruciate Ligament often take place when the knee adopts a position known as ‘dynamic valgus’. This is where the foot is planted and the knee is slightly bent forward and rotated across the midline of the body. This is common when performing a sidestep cutting manoeuvre in sport.
The Anterior Cruciate Ligament can also be traumatically damaged, often when one receives a direct impact from the front of the thigh while the leg is in a stable position. For example, a standing football player is tackled sideways when his feet are firmly planted.
When the ACL is injured most people will state that they heard an audible ‘pop’ or ‘snap’. There will be immediate swelling, instability and severe pain. Few ACL complete tears heal by themselves, so you will likely be referred to an orthopaedic knee surgeon. The surgeon will assess your knee using a variety of specific tests. An MRI scan is often employed to assess the knee to establish an accurate diagnosis before performing surgery.
The reconstruction is often performed using keyhole surgery and tendinous tissue as a graft. Often, this is your own tissue harvested from your hamstrings, knee tendon or quadriceps tendon, although donated tissues can be used in special cases. The graft is positioned between the thigh and shins by drilling tunnels into the bones and using fixation devices and screws to hold it in place.
After the surgery, it is vital that you attend regular physiotherapy for six months to one year of rehabilitation to guide you through your recovery. The physio programme will include swelling management, and a range of movement and strengthening exercises that can be tailored to a specific sport or hobby. These will aid you in returning to your chosen sport with a stable and confident knee.
Have you had ACL reconstruction and want to return to playing sport? Our specialist orthopaedic physiotherapists can see you in your home and we can set up an initial appointment within 24 hours. Contact us today on 0207 884 0374 or email email@example.com.