The anterior cruciate ligament (ACL) is one of several ligaments in the knee that helps provide stability to the joint. ACL injuries can occur for any number of reasons, but it is more common in running and contact sports. Depending on the severity of the injury, there are several approaches to treat the problem
If there is a minor strain to the ACL or the patient has several factors that make surgery not ideal, conservative treatment may be used. In the acute phase of an ACL strain, anti-inflammatory pain medication might be necessary. Beyond pain management, bracing the knee is also important. Bracing can serve as a way to reduce swelling by offering compression and it also provides additional support to the knee. There are several types of knee braces available and your doctor will make a recommendation based on your lifestyle. People who are relatively sedentary can benefit from a brace that acts as a sleeve over the knee, whereas people who are more active may need a hinged brace that provides them with more knee mobility. Conservative treatment may also include physical therapy, which consists of exercises to build strength and stability in the knee.
If the ACL injury results in a tear, it is less common for the tear to be incomplete. Minor tears may benefit from surgery to suture the ligament together. This is often done laparoscopically to minimize the size of the incision and reduce the risk of infection. Once the surgeon visualizes the ACL, a few sutures are used to repair the ligament since the ligament will not heal on its own. After the patient is cleared to resume movement, they will engage in physical therapy to further improve knee pain and function.
Rebuilding the ACL is far more common because most ACL tears are complete or nearly complete. The procedure for rebuilding the ACL is more complicated than a simple repair. Since the ligaments are incapable of regeneration, tissue must be harvested from elsewhere in the body and used to replace the torn ACL. A tendon is typically harvested from the knee cap or back of the thigh to serve as the new ACL. In some instances, a tendon may be harvested from a cadaver. This tendon is transplanted to the location of the ACL and adhered to the bone using screws. Most rebuilding surgeries are also done laparoscopically. Recovery is usually more challenging after rebuilding the ACL because the patient needs to engage in significant rehabilitation of the knee. Fortunately, most people who have their ACL rebuilt are usually able to return to their normal activities after several months of intensive physical therapy.
The ACL is an important ligament that provides support and stability to the knee joint. Depending on the extent of the injury, significant surgery and rehabilitation may be necessary to return to your pre-injury mobility.
To learn more about ACL repair and other treatment approaches, contact a local medical health professional.