The anterior cruciate ligament (ACL) is a band of fibrous tissue that connects the thigh bone (femur) to the shin bone (tibia). The function is to limit twisting (rotational) forces through the knee and prevent forward translation of the femur on the tibia. The ACL is commonly strained or ruptured whilst playing running sports or snow sports. The injury occurs mostly when quickly changing direction, landing from a jump or decelerating suddenly. The knee normally gives way and players report hearing a ‘pop’ or ‘crack’. Snow sports involving impact at high or low speeds, incorrect fall out techniques or a failed binding release can also result in the knee giving way due to injury to the ACL.
Typically the knee swells rapidly (within the first few hours following the initial injury), so the initial phase of treatment should be RICER (rest, ice, compression, elevation and referral to either a physiotherapist or Sports physician). Crutches may also be required in the early stages.
Your physiotherapist or sports physician may send you for scans (X-ray, MRI or CT) of your knee to determine the extent of damage. Further referral to an orthopaedic surgeon may be required if a complete rupture of your ACL has occurred.
Prior to most surgical treatment a period of conservative treatment (physiotherapy) is advised to reduce swelling, restore the knee joint range of motion, and build muscle bulk to help stabilise the joint. After the operation, physiotherapy recommences to overcome the effects of surgery, such as swelling, pain and joint stiffness. Returning to sport and activities of daily life is can vary from patient to patient depending on previous injury status and the extent of the knee injury. Generally, most patients can return to sport requiring a change on direction around 6 months post surgery.
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