ACL Injury

Prevention

The best way to prevent ACL injuries is to improve conditioning, and do strengthening and stability exercises of the thigh muscles, especially the hamstrings. “Jump training” and awareness of risks are helpful. Avoiding cleats and high heels will help prevent some injuries. Check sports gear. Ski bindings should be adjusted by a professional to release properly in a fall. Wearing a knee brace does not prevent ACL injuries.

Treatment

The goal of treatment is restoring function and stability, reducing pain, preventing re-injury, additional damage, and osteoarthritis. At the time of injury the leg should be elevated, preferably above the heart. Ice should be applied, with care taken to prevent cold injury to the skin. It may be necessary to use a splint and/or crutches. Pain medication may be necessary, usually acetaminophen or non-steroidal, anti-inflammatory drugs (NSAIDs) are recommended. The best choice of treatments, and whether or not surgical repair is performed, is a complex decision. The patient’s age and general health, activity level, physical conditioning, occupation, type of sport and degree of participation, if any, as well as history of previous injury are relevant. Whether or not surgery is performed, the patient can expect weeks to months of physical therapy/rehabilitation.

Recent Debate and Development

Most ACL tears, whether partial or complete, cannot be sutured (sewn) back together. A graft is required. There is much research, ongoing, in regard to the best material for grafting. The graft supplies strength and scaffolding for new ligament tissue growth. Various human tissues are used, as well as experimental artificial materials and techniques. There is constant research devoted to rehabilitation research, type, frequency, and duration, for this debilitating injury, prone to complications.

More Information

Mayo Clinic: http://www.mayoclinic.com/health/acl-injury/DS00898
American Academy of Orthopaedic Surgeons: http://orthoinfo.aaos.org/topic.cfm?topic=A00549
American Academy of Family Physicians: http://www.aafp.org/afp/2010/1015/p917.html

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