The anterior cruciate ligament is a ligamentous stabiliser that runs through the middle of the knee. It is usually injured during sporting activities involving a sudden impact, forcefull sidestep or by landing in an uncontrolled way after a jump. Rugby is the most common sport causing ACL tears, but netball, soccer hockey and tennis also plays a role.
The patient usually experience pain and rapid swelling shortly after the accident. You are usually unable to complete your game. The pain and swelling will subside gradually, but when you try to play sport again, you experience recurrent episodes of knee instability. (The knee feels as if it collapses under you, or as if it wants to bend backwards). Unfortunately the anterior cruciate ligament has virtually no natural healing potential.
In most cases the anterior cruciate ligament is reconstructed using another tendon in the knee (hamstring or quadriceps tendon). Minimally invasive arthroscopic surgery is performed and anatomic footprint reconstructive techniques are used to reconstruct your ligament. Patients usually sleep in hospital for 1 or 2 nights. You are required to protect your knee with crutches and/or bracing for the first 6 weeks after the operation.
Progressive rehabilitation follows and patients can return to sports involving directional changes after 8 to 9 months. The rehabilitation program are individualised and overseen by a physiotherapist and/or biokineticist.
Non-surgical treatment is indicated for older and lower demand patients.
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