The ACL is a 3-3.5cm band of fibrous tissue, it is one of the four main ligaments in the knee which work together to stabilise the knee and prevent excessive movement of the joint. Most commonly, the ACL is injured during sporting activity from pivoting or landing from a jump rather than from contact. A frequent example of this is during skiing when bindings fail to release resulting in the knee twisting. High impact trauma such as car accidents and falls from a height can also results in ACL tears. Females are at a higher risk of tears due to the generally smaller ligaments and increased laxity.
The most common symptoms when patients sustain an ACL injury is sudden knee pain and the knee giving way. This is followed by swelling. Whilst the swelling and pain will often improve, the instability will be persistent and the knee becomes unstable on any form of twisting movements, especially whilst running.
The history taking and examination that will take place during your consultation will help with diagnosis. Imaging will also be taken – x-rays and MRI scans help assess the knee in more detail and will help rule out other associated injuries. Special tests are also carried out in clinic as part of the physical examination to test the stability of the knee.
Intensive physiotherapy is used to maximise knee strength and stability as well as to teaching you to avoid positions and movements that would worsen your symptoms. Sometimes, modifying lifestyle and choice of sports along with physiotherapy returns patients to their previous level of function and they are able to avoid surgery.
Surgery is indicated if you need an intact ACL in order to continue playing sports or if you have persistent instability. The damaged ACL is removed and a new one is reconstructed using grafts. The graft is typically taken from your own hamstring muscles.
Most people return to their normal activities in 2 weeks but return to non-competitive sports takes 4-6 months and return to competitive sports takes 9-12 months.
I had a total knee replacement done and had the best care. Yes did experience a long wait to go to surgery but that’s expected in most hospitals. Was in for 3 days and couldn’t fault the care, nurses and cleanliness of the hospital. Lovely food. One nurse in particular always managed to make me smile