PRESENTATION OUTLINE
One day Sally was running in track. That day she was in a hurry so she didn't stretch before the run. She was at full speed when she over-strided, and fell to the ground wincing in pain.
When the ACL ligament is stretched too far and ruptures, the blood vessels inside the ligament rupture as well, and this blood fills the knee joint, causing the knee to swell.
At the time of an ACL injury, signs and symptoms may include:
-A loud pop sound
-Severe pain and inability to continue activity
-Knee swelling that usually worsens for hours after the injury occurs
-A feeling of instability or giving way with weight bearing
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ACL reconstruction surgery is commonly, and improperly, referred to as an "ACL repair." Unfortunately, a torn ACL cannot be repaired. Rather, the torn ligament must be entirely removed, and a new ACL must be reconstructed using other healthy tissue. It is not possible to repair the torn ACL by simply reconnecting the torn ends. The correct terminology is an ACL reconstruction, not an ACL repair.
the type of reconstruction must be decided. The major decision is whether to use tissue obtained from your body to create a new ACL, or to use tissue from a donor to make the new ACL. There are various pros and cons with each type of graft. There are also newer techniques, such as the "double-bundle ACL reconstruction, that may be offered to you. These techniques have not been shown to be more effective at getting people back to their pre-injury level of activities.
The ACL reconstruction surgery lasts about 1 1/2 to 2 hours, depending on the graft choice and any other work that may need to be done in the knee joint.
Following the procedure, you will be given crutches and may be given a knee brace. The decision to use a knee brace is controversial and can be discussed with your doctor. Some doctors also use a CPM (continuous passive motion) machine in the days following the ACL reconstruction. This is also controversial and may be discussed with your doctor.
A rehab program should include:
-Flexibility exercises.
-Strengthening exercises.
-Endurance activities.
-Coordination and agility training (for competitive athletes).
-The function of muscles in the injured leg should be as strong as in the uninjured leg before you return to normal activities.
The program usually includes treatment with a physical therapist at a therapy center and home treatment in your home or at a gym or health club. Typically, as you see less of your therapist, you do more on your own.
