Tearing you Anterior Cruciate Ligament (ACL) can be a devistating injury. There are several treament options available. Both non-operative and operative treatment options should be explored. A select few may be able to "cope" and can function well with a ACL deficient knee. Others may require surgical intervention to repair, augment or reconstruct their ACL. A common scenerio is a non-contact injury occuring during a cutting movement. Patients often decribe hearing a "pop" and their knee buckles. Significant swelling is often present. Some will be evaluated by a trainer, while others will go to an emergency room or come to my office. A history, physical exam and x-rays will be preformed. An MRI may be preformed to confirm your diagnosis and evaluate any other pathology, like a meniscal tear, that may be present. Recent studies show that a Pre-habilitation program may be beneficial for some individuals, so PT may be recommended. Ice, NSAIDs, bracing and range of motion program would be initiated. A discussion with your Orthopedist would include all options and the risks and benfits of these options. If surgical intervention is decided on there are more options available. If your MRI shows a tear of the ACL toward to top part you may be a candidate for an ACL repair, or ACL preservation procedure. Advanced arthroscopic techniques have made this option possible. If your tear is mid-substance (most common) or tissue quality is poor then ACL reconstruction could be the procedure of choice. There are many options for ACL reconstruction surgery and which option is best for you will be based on your age, activity level, sports you participate in and what is best in your surgeons hands. Graft choices include your own tissue, autograft, or cadaveric tissue, allograft. Most common grafts are hamstring tendons, quad tendon, or bone- patellar tendon - bone autograft or allograft. Surgery is usually preformed in an out patient setting and you often leave with a brace, crutches and an ice machine. Physical Therapy is started early to avoid stiffness. PT firsts focuses on range of motion, then strengthening, then sports specific drills. Patients can usually return to sport in about 6 months, but don't feel fully back to prior level of play until about 9 - 12 months. There are also techniques to avoid injuring your ACL and this will a topic for another Blog post. If you have any questions please visit Specialtyortho.org, or Call the Ridgewood, New Jersey office at 201-447-1188. Dr. David P. Rudman, board certified in Orthopaedic Surgery, fellowship trained in Sports Medicine, Shoulder and Knee Surgery, would be happy to visit with you.
Apr 26
