Anterior Cruciate Ligament Injury

The anterior cruciate ligament (ACL) is a fundamental anatomical structure commonly affected in sports-related injuries, crucial for providing stability to the knee joint. Given its inability to naturally heal, surgical reconstruction is imperative to preserve its functionality. Through surgical intervention that restores normal knee kinematics, the onset of arthritis in the future knee can be averted. Failure to address abnormal knee movement post-ACL injury through surgery may lead to inevitable pain and restricted mobility in the knees over time.

What are the symptoms of anterior cruciate ligament injuries?

During athletic activities or traumatic incidents, a sudden sensation of ligament rupture in the knee is experienced by the patient, accompanied by intense pain and swelling due to internal bleeding from the torn ligament. The athlete is forced to discontinue the competition, unable to continue. The patient may report a sensation of a popping sound in the knee during sports. As pain and swelling subside, a sense of emptiness and instability in the knee arises when making sudden turns or descending stairs. Engaging in sports, abrupt stops, and landing after jumping can trigger severe knee buckling episodes. In the chronic phase, typically no pain or swelling is experienced during these occurrences. Pain and swelling, if present, may indicate concomitant meniscus injury and cartilage damage.

How is the diagnosis made in anterior cruciate ligament injury?

A detailed history of the event is crucial in patients suspected of anterior cruciate ligament injury. In the initial stages, conducting a thorough examination is often challenging due to knee swelling and limited range of motion. Reassessment is recommended 7 to 10 days post-injury. While diagnosis can often be established through physical examination, imaging studies are essential for confirmation. Magnetic resonance imaging (MRI) is the most valuable diagnostic modality available. X-ray imaging may be performed initially to rule out any fractures following trauma.

Anterior cruciate ligament surgery process

The surgical procedure may be carried out under general anesthesia or regional anesthesia. Patient preference plays a significant role in this decision, alongside the patient's comorbidities. Preoperative placement of an epidural catheter or peripheral nerve blocks ensures postoperative pain management, alleviating immediate surgical discomfort. The surgery typically lasts around 1.5 hours and is conducted arthroscopically. The graft used for ligament reconstruction is usually sourced from the patient, commonly a hamstring graft from the posterior aspect of the knee or a patellar tendon graft from the anterior knee region.

Post-operative process

Hospitalization post-surgery ranges from 1 to 3 days. Patients are able to ambulate with the aid of crutches once the effects of anesthesia diminish. The rehabilitation program is tailored to the individual based on the specific procedures performed. The autograft harvested from the patient's own body does not impede daily activities or sports participation.