ACL injury

Anterior cruciate ligament injury is when the anterior cruciate ligament (ACL) is either stretched, partially torn, or completely torn. The most common injury is a complete tear. Symptoms include pain, a popping sound during injury, instability of the knee, and joint swelling. Swelling generally appears within a couple of hours. In approximately 50% of cases, other structures of the knee such as surrounding ligaments, cartilage, or meniscus are damaged. Anterior cruciate ligament injury is when the anterior cruciate ligament (ACL) is either stretched, partially torn, or completely torn. The most common injury is a complete tear. Symptoms include pain, a popping sound during injury, instability of the knee, and joint swelling. Swelling generally appears within a couple of hours. In approximately 50% of cases, other structures of the knee such as surrounding ligaments, cartilage, or meniscus are damaged. The underlying mechanism often involves a rapid change in direction, sudden stop, landing after a jump, or direct contact to the knee. It is more common in athletes, particularly those who participate in alpine skiing, football (soccer), American football, or basketball. Diagnosis is typically made by physical examination and is sometimes supported by magnetic resonance imaging (MRI). Physical examination will often show tenderness around the knee joint, reduced range of motion of the knee, and increased looseness of the joint. Prevention is by neuromuscular training and core strengthening. Treatment recommendations depend on desired level of activity. In those with low levels of future activity, nonsurgical management including bracing and physiotherapy may be sufficient. In those with high activity levels, surgical repair via arthroscopic anterior cruciate ligament reconstruction is often recommended. This involves replacement with a tendon taken from another area of the body or from a cadaver. Following surgery rehabilitation involves slowly expanding the range of motion of the joint, and strengthening the muscles around the knee. Surgery, if recommended, is generally not performed until the initial inflammation from the injury has resolved. About 200,000 people are affected per year in the United States. In some sports, females have a higher risk of ACL injury, while in others, both sexes are equally affected. Many people with a complete tear who do not receive surgery are unable to play sports, and may develop osteoarthritis. When an individual has an ACL injury, they are likely to hear a 'pop' in their knee followed by pain and swelling. They may also experience instability in the knee once they resume walking and other activities, as the ligament can no longer stabilize the knee joint and keep the tibia from sliding forward. Reduced range of motion of the knee and tenderness along the joint line are also common signs of an acute ACL injury. The pain and swelling may resolve on its own; however, the knee will remain unstable and returning to sport without treatment may result in further damage to the knee.