What you need to know about the ACL:
- The ACL is short for the Anterior Cruciate Ligament
- The ACL is one of the 2 strong ligaments inside the knee joint. The other is the PCL (posterior cruciate ligament).
- Cruciate means 'crossing'. The 2 ligaments inside the knee 'cross' each other.
- The primary function of the ACL is to control forward movement of the tibia on the femur as well as to restrain excessive inward rotation of the tibia in relation to the femur.
- Injuries to the ACL occurs more commonly in athletes but occur commonly in non-athletes as well.
- Injuries to the ACL occur most often in contact sports or activities requiring sudden stops and turns.
- Not all ACL injuries need surgery.
- The decision as to whether to have surgery will depend on how active the person is.
- A torn ACL cannot simply be repaired. The torn ends cannot just be brought together and fixed. It will not heal or hold.
- Surgery for a torn ACL is therefore called a 'Reconstruction". The ACL is replaced by a tendon that takes the place of the ACL.
- Two common tendons used in the reconstruction of the ACL are the patellar tendon and the hamstring tendon.
- ACL reconstruction can now be performed on an outpatient basis using keyhole surgery (arthoscopically).
- The rehabilitation program following ACL reconstruction is very important and has a significant impact on the outcome of the surgery.
- Most therapy programs follow specific guidelines and protocols.
- For most individuals, ACL reconstruction can restore stability to the knee and will allow them return to previous work and vigorous athletic activities usually without any compromises.
Here are some frequently asked questions related to anterior cruciate ligament tears.
Q: I have been recently diagnosed with an ACL tear and my physician wants to do an MRI to confirm his diagnosis. Wouldn't a plain x-ray be much less expensive and less time-consuming?
A: Plain x-ray films will only show bone tissue rather than soft tissue structure. Since the ligament is soft tissue in nature it will not show on an x-ray.
Q: How much physical therapy will I need after the ACL reconstruction?
A: One of the main priorities after ACL reconstruction is to regain the knee range of motion. This, along with establishing a good strengthening program, is usually best done two-three times per week for the first four-six weeks. Because many insurance policies will not cover this many visits to the therapist, an independent home program may need to be instructed earlier. It is important to comply with any exercise program at home and in a clinical setting.
Q: My friend had her ACL reconstructed and was allowed to discontinue the brace after two weeks. I have been instructed to keep wearing my brace for four weeks after surgery. Why the difference in recommendations?
A: Every surgeon has different experiences and philosophies. Also, each particular injury is different and surgeries are different. The important thing is to adhere to the surgeon's recommendation for optimal results.
Q: What kind of brace will I be using when I return to my sport after rehabilitation?
A: There are several types of braces on the market that protect the knee joint. They are all relatively light and user-friendly. One important aspect some ACL braces have is that in order to unload stress on the ACL graft, the sequence of fastening the straps of the brace (usually four or five) is very important.
Q: I like to snow and water ski. Can I still do these activities after ACL reconstruction?
A: Unless the surgeon advises otherwise, most people return to enjoying both of these sports with the use of a brace. However, remember every individual injury is different. Following the recommendations of the surgeon is of utmost importance.