Friday, 18 January 2019

Sporting an ACL injury

09 January 2019 | Features | By Dr. Chirag Thonse

The ACL could be damaged during sporting activities, road accidents or twisting injury to the knee joint.

An injury- a physical trauma to the body can occur unexpectedly at any point, it can either be a temporary one or might hold on for long. A sportsperson, considering their professional occasional suffer physical injuries as their profession highly depends on physical activities. These injuries have to be dealt properly with proper guidance, if not, it could further restrict movement and cause hindrance in day to day activities.

Our bones are connected to each other by ligaments. There are four ligaments in the knee joint which holds the knee bones together and provide stability to the knee joint. The two side ligaments are called the collateral ligaments ( medial and lateral) which provides the sidewards stability to the knee.  The two ligaments inside the knee joint which cross each other in the form of an “X” are called the cruciate ligaments, the front – Anterior Cruciate Ligament (ACL), the behind Posterior Cruciate Ligament PCL. The cruciate ligaments control the back and forth movement of the knee joint. The ACL runs diagonally in the middle of the knee, it prevents the tibia from sliding out in front of the femur, also it provides rotational stability to the knee joint.

The ACL could be damaged during sporting activities, road accidents or twisting injury to the knee joint. About half of the ACL injuries occur in association with other injuries to the knee like – meniscus injuries, cartilage injuries, or collateral ligament injuries. Partial injuries to the ACL is rare, most ACL injuries are complete or close to a complete tear.

When ACL is injured one could feel a pop sensation, or a giving away sensation in the knee joint, there could be swelling, pain and decreased movement of the knee joint. A person would experience discomfort and loss of stability while moving the knee joint. If neglected, one might experience repeated twisting/ buckling of the knee while running down the stairs or playing sports. Such repeated buckling episodes would subject the knee to other internal damages and eventually early wearing of the knee ( early Arthritis). An MRI imaging is usually suggested to confirm the diagnosis and rule out other injuries associated with the knee.

Treatment:

Treatment of an ACL tear will vary from patient to patient as per the severity. Younger individuals usually require surgery to safely return to their pre injury activities and sports. Elderly individuals performing light activities should go in for a non-surgical treatment like bracing and physical therapy.

A torn ACL will not heal without a surgery, it is usually reconstructed with a new ligament by an Arthroscopy (keyhole) procedure, which could be done on a daycare basis with minimal pain and discomfort to the patient.

People with ACL are also at a higher risk of developing osteoarthritis. However, it is important to consult a doctor and take proper care of the injury. Proper training, exercises and therapies can also help reduce the risk of ACL.

 

Dr. Chirag Thonse, Specialist in sports injuries and joint replacement surgeries, Fortis Hospital, Bengaluru

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