Treatment of Anterior Cruciate Ligament Injury
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Catholic Clinic Koblenz-Montabaur
Department of Adult and Pediatric Orthopedics, Traumatology, Endoprosthetics
Academic Hospital Brothers of Mercy Munich
Department of Orthopedics and Traumatology
Orthopedic Center Munich East Munich
Department of Orthopedics
Academic Municipal Hospital Karlsruhe
Department of Adult and Pediatric Traumatology, Hand and Orthopedic Surgery
Vitos Orthopedic Clinic Kassel
Department of Adult and Pediatric General Orthopedics, Trauma Surgery
University Hospital Ulm
Department of Adult and Pediatric Orthopedics
University Hospital Heidelberg
Department of Adult and Pediatric Orthopedics, Traumatology
University Hospital Frankfurt am Main
Department of Adult and Pediatric Orthopedics, Special Orthopedic Surgery and Rheumatic Orthopedics
Charite University Hospital Berlin
Department of Adult and Pediatric Orthopedics, Traumatology
University Hospital Würzburg
Department of Adult and Pediatric Orthopedics
University Hospital Rechts der Isar Munich
Department of Adult and Pediatric Orthopedics, Sports Medicine
University Hospital of Ludwig Maximilian University of Munich
Department of Traumatology and Reconstructive Surgery
University Hospital Carl Gustav Carus Dresden
Department for Adult and Pediatric Orthopedics, Trauma Surgery
University Hospital Tuebingen
Department of Adult and Pediatric Orthopedics
University Hospital Muenster
Department of General Orthopedics and Orthopedic Oncology
Anterior cruciate ligament is one part of two ligaments, that are situated in human knee. This ligament is also called cruciate, because it is formed in a crucial position. To understand it better, imagine letter X, that is formed by joints in the upper knee area. Anterior cruciate ligament blocks the whole flexibility of the knee and it can also bring excrutiating pain. Anterior cruciate ligament is sometimes called ACL, as in abbreviation. Anterior cruciate ligament forms in the lowest thigh bone, that is close to upper part the knee.
Anterior cruciate ligament pain can be quite severe in the first moments after the injury. Only in the USA 100 000 of anterior ligament injuries are recorded annualy. Anterior ligament injuries usually happen during sport games. All athletes and sportsmen are under the risk of anterior ligament, as the injury that provokes ACL usually happens when doing some intense physical activity. The most dangerous and severe sports that can result in knee injury are cutting and pivoting sports. Such sports are football, soccer, hockey and basketball. In most cases, the whole reconctruction of anterior ligament is required. The damage that is done to the knee can sometimes be incurable.
When the injury happened, the most important thing to do is to provide relief for the injured knee and to diminish pain in the cruciate ligament. Secondly, the reduction of joint swelling must be performed by all means, otherwise there is a risk that knee won`t be cured completely. After that, the activity of the lower human limb must be restored. Once the damage has been found, it is necessary to protect and preserve the injured foot from unnecessary movements. Otherwise, it can cause additional damage to the knee and the pain, that has been relieved, can appear again. It is better not to move or move only with the special help of nurses and doctors.
The main symptom of anterior ligament` injury is the partial or whole instability of the knee joint. If it is not treated in time, the injured joint can develop arthritis, localized in this area. Another symptom of anterior cruciate ligament is swelling of the joint, that appears in the matter of seconds after the injury. In such case the indicator for disease is reddish skin around the ill area. Other anterior cruciate ligament symptoms of the injury is the unmistakable feeling that the knee is broken. Another anterior ligament injury symptom is the lack of usual blood that always appears if a person fell hard on the knee. The reason for that is that all blood diminishes if anterior ligament is injured. Overall symptoms include:
- Pain in the knee
- Swelling
- Redness
- Fever
- Inability to walk long distances
- X- Ray of the joint can show if the ligament is broken
- Ultrasound shows the source of inflammation and swelling
- MRI is used in rare cases, most often for sportsmen to understand if a person will be able to play professionally in future
- Arthroscopic surgery. During this surgery the patient`s ligament in replaced in the knee. In such case the tissue from patient`s or donor`s body can be used
- Arthroscopic or open reconstruction and autotransplantation. During this surgery doctors use autograft. Autograft is the tissue of the patient, that is extracted from his or her body to reconstruct one part of the injured knee
- During “the terrible riad” surgery all parts of the knee are teared and the anterior cruciate ligament repair must be done immediately.
Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed