Common Knee Problems :: Anterior Cruciate Ligament Injuries
A football weekend hardly passes without news of an athlete sidelined by an anterior cruciate ligament(ACL) injury. Packer fans agonized as Robert Brooks went down with a knee injury. Among his injuries was an ACL tear. San Francisco 49er Jerry Rice's season came abruptly to a halt with a knee injury, which included an ACL tear.The ACL is located in the center of the knee, and connects the thigh bone (femur) to the shin bone (tibia). It lies next to the posterior cruciate ligament (PCL), and crosses it, thus the name "cruciate" ligament. The ACL serves a very critical function in providing stability to the knee, especially the knee of an athlete. The ACL allows us to plant a foot firmly on the ground, and change our direction. In other words, it allows the athlete to make a "cut." This is obviously important for a running back or receiver, but is equally so in many other sports, and even in non-sports related daily activities.
Football, baseball, soccer, skiing, and basketball are sports associated with an increased risk of ACL injury. One study of college football players reported 42 ACL injuries per thousand players at risk per year, or a 16 percent chance of an ACL injury in a four year collegiate career. This represents a 100-fold increase in injury compared with the general population.
What treatment options exist for the individual with an ACL injury? The cornerstone of all treatment for both the athlete and non-athlete is rehabilitation. An aggressive program of strengthening will maximize knee function and insure full range of motion. Approximately one-third of patients with an ACL injury will not require any type of reconstruction, and will be very functional with rehabilitation alone. Another one-third may avoid surgery by lowering their activity level, using a brace, and aggressive rehabilitation (always!). Approximately one-third of patients will ultimately require a reconstructive procedure.
Age and activity level seem to be the most important factors in determining who will require surgery and who will do well with rehabilitation alone. The younger and more active a patient's lifestyle, the more likely he/she will require reconstruction to return them to their pre-injury level of function. Each patient is different and the decision to reconstruct the ACL should be made on an individual basis. Your surgeon will be able to discuss the advantages and disadvantages of each type of treatment, and together you may decide which is best for your lifestyle. Regardless of whether reconstruction is required, a dedication to rehabilitation is necessary to maximize one's recovery.
