Partial ACL injury- all delimmas resolved!
Partial ACL injury is a common diagnosis which may land you up in a delimma of getting under the knife or not. This article answers all your queries and guides you thrugh the right treatment you need!!
Anterior Cruciate ligament (ACL) is a major stabilizer of the knee which prevents the knee joint from subluxating (partially dislocating) while running, jumping, climbing downstairs and playing competitive sports. A person suffers a fall/injury and may incur ACL injury, which presents with sudden pain and swelling in the knee.
Most patients land up to their nearest general practitioner after the injury. After a breif history, usually an MRI scan is asked for. Patients present with the MRI to their Orthopedic/Sports Physician counterparts after being refered. The major concerns of patients start after they go through the MRI report at home.
In a usual scenario where the MRI report indicates a partial ACL tear there are common FAQ’s that come to the mind!!
What does Partial ACL injury mean?
ACL is a bundle of fibres and a partial injury suggests that the force of trauma has lead to swelling +/- tear in some fibres of the ligament. Most patients have complaints of pain and swelling in the knee. Some may also complaint of instability or lack of confidence while doing physical activities.
Partial tear can be classified as grade 1 and grade 2. These are indicated in an MRI scan. Your doctor with the clinical examination will take help of the MRI scan and evaluate the grade. Though MRI sections are dificult to interpret by a layman, technically speaking, they show up as a contused (WHITE signal) on T2 scan with an intact ACL (Black signal) on T1 film.
How do I know if i need a surgery??
Before the doctor clinically evaluates and sends the patient for radiological confirmation(MRI), history and symptomatology is very important. All the patients will present with pain and swelling after injury which will usually settle down in a week or two.
Small subset will have persisting pain, swelling along with a feeling of popping out of the knee(instability). Patients presenting with compliants of reccurent instability are ideal candidates of surgery.
When should i get a surgery done??
Surgical procedure is usually not an emergency and in case needed (if suggested by your doctor) can be performed on an urgent basis in selected cases.
What should i expect from the surgery ?
Instability is the primary problem which can be corrected post surgery. Any pain due to cartilage/meniscal injuries or clicking noises in the joint may not completely resolve with surgery for reconstruction of the ligament.
Post operative demand of the patient should be assessed and only in cases who have demands of active lifestyle should be offered surgery. ACL tear is commonly seen in elderly patients of osteo-arthritis but needs no intervention. It is always recommended that any radiological investigations should only be done once your doctor recommends.
How does the doctor know if i need a surgery ??
There are three parameters of how your doctor will assess the condition. History/symptomatology, clinical examination, radiological picture. All the three if co-relate, usually indicates a surgical candidate. In case of there is incoherence, your doctor might advise you a Diagnostic Arthroscopy & evaluation following which there might be need for reconstruction.
Is there a Non-Surgical treatment for partial ACL injury ?
Surgical/Non surgical treatment depends on coherence of the fore-mentioned parameters. Most patients of partial ACL injury, who don’t complaint of instability are treated conservatively with exercises and rehabilitation. Quadriceps and Vastus medialis strengthening along with hamstring stretches are mainstay in treating patients. Specific rehabilitation aims at establishing Range of motion, Strength training and balance training in the same order. Your doctor will refer you to a Physical therapist for supervised physiotherapy and rehabilitation programme.
How many weeks of physiotherapy is essential for recovery??
Exercises for upto 6 weeks are recommended to recover from ACL sprain. It is essential to take adequate rest to reduce swelling and pain before starting with physical therapy.