Ligament Acl Tear

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What Is Anterior Cruciate Ligament?

The anterior cruciate ligament (ACL) is one of the main ligaments of the knee joint. A ligament is a tough, flexible band of tissue that holds bones together. The ACL helps to keep the knee joint stable.

What Is an ACL Tear?

The knee is a weight-bearing joint that straightens, bends, twists, and rotates. All of these movements increase the risk of knee injuries. The ACL can tear if an injury stretches the ligament too much. An ACL tear can happen because of road traffic accident, sports injury or even after a simple fall. The ligament tear might be partial (through a part of the ACL) or complete (all the way through the ACL).

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Sports injury to the knee leading to ACL tear

Why ACL tear is common in women?

OsRates of ACL tears are about eight times more frequent in women than in men. Unfortunately, it is unclear as to why women are more susceptible to ACL injury. Some of the theories include a) differences in knee anatomy between men and women, b) hormonal changes in women and c) varied biomechanical properties of the ACL in women.

How can we prevent ACL tear in sports persons?

The best way to reduce the risk of ACL tear is by undergoing neuromuscular training programs before engaging in sports activities.

Components of the program include a) Warm-up b) Stretching muscles (calf, quadriceps, hamstring, and inner thigh), c) Strengthening exercises, d) Plyometrics and Agilities.

What are the symptoms of ACL tear?

You may hear a sudden pop and/or feel a sudden shift in your joint at the time of an ACL injury. Most people are surprised at how loud the pop can be, and sometimes bystanders can even hear it on the side line of a football or soccer game.

Right after an ACL tear, you can rapidly develop  hemarthrosis  (bleeding into your joint). This causes swelling, redness, warmth, bruising, pain, and a bubbling sensation in the joint.

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Knee position while jumping
Video showing tests for Ligament (ACL) Tear

What are the tests for ACL tear?

Apart from detailed clinical examination by the doctor, you may need to have an X- ray of the knee, which can identify bone fractures. A magnetic resonance imaging (MRI) study may also be used to determine whether your ligament is torn, whether you have sustained damage to your cartilage, and to look for signs of other associated injuries in the knee.

Why does the ACL fail to heal?

Unlike other ligaments of the knee joint, the ACL passes through the joint and is surrounded by joint fluid. While ligaments heal by scar formation, the joint fluid is designed to dissolve and prevent blood clotting within the joint. Without blood clot, scar tissue does not form. The result is that the ACL rarely heals in continuity.

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MRI showing normal ACL, torn ACL and absent ACL because of old ACL tear.
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The fluid inside knee joint prevents the healing of torn ACL

What is the treatment for ACL tear?

Many people who experience an ACL tear start to feel better within a few weeks of the injury. Most people do not need surgery after an ACL tear, especially if the ACL was only partially torn. If you don't play sports, and if you don't have an unstable knee, then you may not need ACL surgery.

Surgery is advised if you have persistent symptoms of knee instability. The usual surgery for an ACL tear is called an ACL reconstruction. A repair of the ligament is not usually possible, so the ligament is reconstructed using another tendon or ligament. Several types of graft can be used to reconstruct the torn ACL. Using one’s own ligament (auto graft) results in stronger graft healing with better knee function.