ACL Injury/ ACL Tear

Overview:

ACL or the anterior cruciate ligament is a stabiliser of the knee which prevents forward subluxation (slipping of bone from joint) of the leg over the thigh. It is a bundle consisting of intertwined fibres and connects the leg bone to the thigh bone. ACL injury almost always occurs as a result of a Twisting/Pivoting force involving the knee joint.

The causal injury may be collision sports or typically landing phase post jump. Some patients may also give a history of a road traffic accident involving a twist. ACL injury may also be associated with concomitant injury to other soft tissue and bony structures.

ACL injury usually presents with a sudden pain and a pop sound followed by immense swelling in th affected knee. The ACL injury leads to a debilitating pain and severely restricted movement. Routine tests like a skiagram may be misleading. The initial management usually is based on PRICE therapy and the swelling pain settles within 2 weeks of insult.

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What to do if you have ACL Injury?

The initial management consists of :

P : Prevent Re-Injury/ Stop playing immediately

R: Rest to affected part; Immobilise it

I : Ice packs

C: Compression bandage

E: Elevate the affected part

How to diagnose the ACL tear or ACL injury ?

  1. History of twisting injury to knee
  2. Swelling and Pain
  3. Instability of injured leg
  4. Under-confidence while sporting
  5. Inability to change directions swiftly
  6. Cautious walking over uneven surface
  7. Restricted range of movement
  8. Locked knee

The Orthopedic/Physical therapist will in addition examine for confirming findings. Also they may order for investigations like Skiagrams and MRI for being double sure and ruling out concomitant injuries. They will also counsel for the types of treatment options for patients with ACL tear.

Can ACL tear heal without surgery?

ACL tear can heal without surgery in cases where only a grade 1 or grade 2 sprain is evident and the fibres are found to be intact with a mild swelling in the ligament. In cases with a complete tear or grade 3 sprain or high grade sprain/tear, it is usually associated with instability and needs surgical intervention.

Surgical intervention is always followed by vigorous rehabilitation in all cases and it is advised to undergo all phases of physiotherapy.

What is Arthroscopic ACL surgery ?

Arthroscopic means any joint surgery using a minimally invasive approach. ACL surgery is done using two minor incisions which make use of specialised equipment (Camera & Instruments) for visualising and performing the surgical procedure. Meet our experts for the best opinion and surgery using the latest advancements.

ACL Tunnels
ACL post-reconstruction
ACL injury treatment in athletes
Knee representing a normal ACL between thigh and leg bone

The surgery is done under spinal/regional anaesthesia and takes about an hours’ time.The graft is fixed at both ends using different implants depending on preference of the patient and the surgeon. The patient is allowed orally from the evening of the surgery and made to ambulate with aid the next day onwards. The patient is guided through in bed exercises for better & faster rehabilitation. For best ACL surgery results please connect to us with your queries.

We are proud to cater to best treatment of ACL injuries in Gurugram. With over a 100 surgeries a year Jyoti Hospital is proud to present best results of ACL reconstruction.

How important is physiotherapy post ACL surgery ?

Physiotherapy plays a pivotal role in regaining range of movement and strength. Phase I aims at full extension and up to 90 degrees of flexion. Use of ambulatory aids like crutches and knee immobilizer is discontinued after two weeks and patient walks unaided hence forth. Phase II starts from the day of suture removal. It focusses on achieving full range of movement. After this at about 12 weeks, phase III starts where the focus remains on strength training. All the previous exercises are added up each time. At about 4 months, proprioception and balance training starts.

The patients usually get back to normal activities of daily living by 6 weeks’ time and back to sports by about 6 months. All patients do not have same response to pain and exercises. The course varies with each individual and no two cases are the same. The cartilage and meniscal injuries associated with the ligament tear define the prognosis of the patient to great extent. We offer all services related to rehabilitation and physiotherapy to bring you back to the field. With the Best in class equipments we assure earliest rehabilitation post surgery.

The video demonstrates an Arthroscopic ACL augmentation surgery in a case of a partial ACL injury presenting with symptoms of instability. Sports persons and high demand patients may suffer from frank symptoms and should be counselled for early surgical treatment to prevent further damage to the joint.

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