Steven M. Erickson, MD, FACP, is board certified in both internal medicine and sports medicine. He serves as medical director of the Banner Concussion Center, which operates the Banner Health Clinic specializing in sports medicine. His office can be reached at (602) 839-7285.
Question: Anterior cruciate ligament injuries are common and devastating in the world of sports medicine. What causes them and how are they treated?
Answer: The anterior cruciate ligament (ACL), located on the inside of the knee, is one of four main ligaments supporting and stabilizing the knee. Certain activities, including both contact and non-contact sports, can put excessive stress on the ligament. When the force of that stress is too great for the ACL to handle, a tear may occur.
Approximately 70 percent of ACL injuries result from non-contact sports and those injuries are often sustained by women. Constant twisting and cutting make women’s soccer a prime source of ACL injuries.
Injury generally occurs when a person twists or moves in one direction while the knee continues moving in the opposite direction. Typically, a person will both hear and feel a pop in the knee, experience knee swelling within hours, lose range of motion and develop a limp.
In the world of sports medicine, any traumatic knee injury with this history is assumed to be an ACL injury until proven otherwise. Due to the severity of the condition, it is advised that anyone suspected of experiencing an ACL injury seek medical attention from someone specializing in sports medicine. Sports medicine specialists can typically tell whether an ACL injury has in fact occurred through a careful history review and physical examination, but a MRI is often obtained to confirm the diagnosis. X-ray also is used to determine whether the bone was impacted as part of the injury.
When it comes to ACL injuries, reconstruction is almost always the recommended course of treatment. Without reconstruction, the athlete will not be able to return to play without symptoms of chronic instability. Furthermore, the laxity of the ligament allows the knee to shift when walking and performing other activities, which, in time, can cause cartilage damage and even lead to premature arthritis.
There are a few approaches to ACL reconstruction, which is an extremely difficult procedure that should be performed by a board-certified orthopedic surgeon who is fellowship-trained in sports medicine and specializes in treating ACL injuries. In the most simplistic of terms, the procedure entails replacing the torn ligament with a new tendon. Recovery and rehabilitation following ACL reconstruction averages between nine and 12 months.
Once thought to be a career-ending injury for athletes, advances in reconstruction techniques now make ACL injuries season-ending injuries that can be overcome if the patient is motivated and committed to his or her rehabilitation program.
Reference the American Orthopaedic Society for Sports Medicine website, www.SportsMed.org, for more information about ACL injuries, prevention tips and treatment options. You can also learn about this and other sports medicine and orthopedic conditions via the Banner Health website at www.BannerHealth.com.