Anterior Cruciate Ligament Research Paper
Intro
Background
One of the most common injuries to the knee involves the anterior cruciate ligament; also known as the ACL. The knee is set up as a central point where three bones meet together forming the knee itself. These bones are the femur (thigh bone), shinbone (tibia) and the kneecap (patella). All of which are connected to other bones by ligaments. The four primary ligaments in the knee are the LCL (lateral collateral ligament), PCL (posterior cruciate ligament), MCL (medial collateral ligament) and the ACL.
Each ligament acts like a rope to anchor each bone together and the entire knee stable. These four ligaments are divided into two categories; collateral ligaments and cruciate ligaments. The collateral ligaments are found …show more content…
on the sides of the knee, the medial ligaments are located on the inside of the knee and the lateral ligaments are on the outside. This prevents the knee from going out when making a sideways movement. Cruciate ligaments are found inside the knee, they cross paths making an “X” shape with the ACL in front of the PCL. The purposes of these are to stop the knee from going to far forward or back and buckling. Despite all of these having a huge role in protecting the knee the ACL takes the crown, without and ACL the tibia would slide out in front of the femur and it also provides rotational stability.
Purpose
The idea behind this paper is to identify the cause of tearing an ACL and how to properly recover and get back to normal activities. Multiple things can occur that will cause the ACL to partially tear and even completely tear. Changing direction rapidly, stopping suddenly, slowing down while running, landing awkwardly after a jump and a direct hit to the knee. Symptoms may include tenderness to the touch, a loss range of motion, and discomfort while walking. After a tear the patient must then decide whether or not to proceed with surgery. Regardless of either decision physical therapy is recommended, if the patient chooses to precede with surgery the discussion on which surgery to do will be begin. There are multiple operations that are done to repair a torn ACL. All of which will create a new graft whether or not the graft is from the patient or a donor. The options include a graft made from the hamstring, patellar tendon, or allograft. As stated before, these can all come from the patient or a donor.
Scope
The focus of this paper will be covering the rehabilitation behind an ACL tear after the surgery. Looking in depth to the different strategies and techniques used to rehab the leg back in the most effective manor.
Discussion
Cause for Injury
An injury to the ACL can occur in a variety of fashions, in noncontact injuries the tear usually occurs when cutting, making a sudden change of direction as well as stopping suddenly and landing from a jump. When any of these instances occur the injured knee will hyperextend while it pivots at the same time putting a lot of stress onto the ACL, which will cause it to either stretch and or tear (Shalvoy 29). In contact sports the leg where the injury occurs is in most cases planted in the ground when contact is made causing hyperextension. The most common sports in which this takes place are, football, basketball, soccer and skiing.
Signs of a torn ACL
In a situation where any of the above occurrences take place the patient can in most cases hear a loud pop sound when the ligament tears. According to doctor Robert Shalvoy, it is not uncommon for people near the action to also hear the pop, as it is very loud and noticeable. Initial pain is common and swelling will begin within and hour or two after the injury. The doctor evaluating will some times ask for the knee to be drained before making a diagnosis, if the fluid contains blood it is likely the ligament was torn. In some cases immediately after the tear, when the trainer or doctor evaluating the injury does a variety of test to check the stability of the knee, it is possible the knee will seem stable because of muscle guarding. Muscle guarding occurs after sustaining an injury, the body has a natural reflex to tense up the muscles around that area to create a brace or support for the injury, because of this the on field test aren’t always affective or accurate (Shalvoy 30). The test preformed shortly after an injury include the Lachman test, the pivot-shift test, and the anterior drawer test. All of these tests put the leg and knee in different positions while they apply pressure to the joint, any unusual motion or unexpected movements of the tibia relative to the femur is a potential sign of a damaged ligament.
Confirming the Injury
The injury its self is all speculation until an official MRI is taken which is the most accurate form of checking for torn ligaments aside from going into the knee through surgery. Once the injury is confirmed as an ACL tear there are two ways to go about recovering. The nonsurgical treatment for an ACL injury focuses on reducing swelling and pain first. The best way to do this is with rest and pain medications such as the standard Tylenol, other treatments for swelling include ice and electric stimulation. Many patients will start physical therapy after the swelling is reduced and movement in the knee starts to increase.
The workouts in PT are designed to help regain normal function of joints and muscles; other exercises will focus on range of motion in order to regain full range of motion in the knee. As physical therapy progresses and strength increases the workouts will progress into more specific movements to help improve the legs stability once again. A brace is recommended and will usually be custom made to ensure a snug fit. The brace is designed to improve stability in the knee and or act as the ACL if injured. Although effective the brace does not ensure that no further damage will occur to the knee ( You’ve torn your ACL. Now what? 5). By not having surgery on an ACL tear other knee injuries are common because of addition stress put on to tendons and ligaments, early knee arthritis also is a side affect.
Surgery
Depending on personal goals post injury as well as the results of physical therapy, surgery will often be recommended to repair the torn ligament. All doctors will suggest regardless of having surgery or not, that one will do several weeks of physical therapy in order to reduce swelling and make the surgery easier. The purpose of this surgery is to keep the tibia from adjusting or moving underneath the femur bone. There are multiple types of surgery for the ACL, which are the following, patellar tendon graft, hamstring tendon graft and an allograft (Knee Ligament Surgery 7). All of these have their pros and cons to each one. Each one of these surgeries can be done arthroscopically, which is a type of surgery done with an arthroscope. Although incisions around the knee are still required, they are not nearly as large nor is the surgeon required to open the joint by doing this. The arthroscope allows the surgeon to have “eyes” in the knee to see while preforming the surgery.
Patellar Tendon
The patellar tendon is a thick band stretching over the kneecap starting at the bottom of the patella and attaches just below the knee to a bumpy bone on the front of the tibia.
Many surgeons prefer to use the patellar tendon while reconstructing the ACL because of its strength and speedy recovery time. It also is easy to make a graft from a patellar tendon because it’s easy to reach. When creating the graft the surgeon removes a portion from the middle of the patella tendon as well as parts of the bone where the patella connected into the tibia and patella. This bone is then used as an anchor when making this graft into the new ACL. A bone drill will create two holes, one in the femur and one into the tibia where the bone from the graft will be put into position there. Two screws are used to hold the bone plugs in place completing the surgery once the new graft is stretched into place (Stener …show more content…
1173).
Hamstring Tendon
Another popular procedure used my many surgeons is that of using a graft of the hamstring tendon. The graft is pulled from part of the hamstring that attaches to the tibia just below the knee joint. The hamstring is a long strong muscle running down the back of the thigh. The most common portion of the hamstring used is called the semitendinosus, this is a tendon that runs along the inside part of the knee and thigh. Also used is the gracilis tendon, this is a strong tendon constructed like a rope with three to four intertwining strands. The surgeon will conjoin the two of these to create one strong band (Ferretti 691). The strength of each hamstring graft is dependent on the patient on which the graft is made from. Similar to the surgery using a patellar tendon two holes are drilled in the tibia and the femur where the graft will be anchored into using screws or staples.
Allograft Reconstruction
Various other materials can also be used to replace a torn ACL. In the case where the best option is to do an allograft reconstruction the surgeon has an option of using tissue from someone else. The tissue is taken from donors or organs when they have passed. It is then sent into a tissue bank where it is cleaned and stored in a freezer until needed. At the time of a surgery the surgeon can call the tissue in for use, the tissue of use is at the choice of the surgeon operating. The allograft can come from the tibialis tendon, patellar tendon, hamstring tendon or even the Achilles tendon (Schindler 34). In this type of surgery the patellar tendon is commonly used because the bone stays attached to the graft, which creates a good anchor that bonds easier with the new body. An allograft is very effective and even can be a quicker recovery since there is no other need to cut into the knee or leg to get a graft from that body.
Complications after surgery
As with any operation there is always risk of complications during or after the surgery. Common problems include, anesthesia complications, thrombophlebitis, infection, problems with the graft and problem at the donor site. Almost all surgeries require some use of anesthesia, problems with anesthesia occur when the patient has an unusual reaction to the drug where the body may have an allergic reaction causing complications.
Blood clots, also known as thrombophlebitis can happen after any surgery but is more common in operations on the hip, pelvis or knee. The clots form in large veins running through the leg causing swelling and pain. The major danger associated with blood clots is the possibility of the clot detaching and traveling up towards ones lungs where the pass ways are much smaller which allow the blockage to be extremely severe causing blood to be cut of to a portion of the lung. To prevent this doctors use two methods, one is by using pressure stockings another is giving patients medication that thins the blood to prevent blood clots (Hagino 1561-62).
Infections can also be an issue but is easily treated with medication. Problems with the graft occur because once the graft is placed the body has to create a new blood network to the graft site. If the body rejects the graft no blood will flow to the graft and it will die causing it to tear again. This will require a second surgery if that occurs. Issues at the donor sight can occur when the graft is taken out of the hamstring from the patients themselves. When this takes place the body will try to compensate for the tendon that was removed by replacing it with scar tissue, yet this scare tissue is weaker then the original tendon which can cause a tear in the hamstring when training heavily (Hagino 1563).
Post Surgery
After surgery is complete and the patient is allowed to return home; which is almost always the same day of the surgery its self, the patient is told to ice heavily as well as elevate the knee. It isn’t long before therapy will begin, 2-3 days out of surgery is a standard start up time in order to start the recovery process. According to Mark Grodski, the longer the wait to start physical therapy the more muscle dystrophy; an occurrence that takes place after surgery when the leg isn’t being used causing muscle to be lost, will take place. A brace will be given to the patient in order to keep the knee straight until the doctor feels the patient has progressed enough to begin adjusting the brace to allow the knee to bend. Crutches are required in order to keep weight off of the knee for up to 4 weeks until the knee can bare weight while walking (Grodski 79).
Rehabilitation
Once settled the patient will soon after begin physical therapy, the initial treatments will be designed to control pain and swelling from the surgery. Doctor Tania Pizzari says “The first goal is to have full extension in the knee as quickly as possible”. In order to achieve this physical therapist will choose workouts to help get thigh muscles to fire again. In the first six weeks after surgery patients are warned not to over work the hamstring, to prevent this many of the hamstring workouts are isometric which keep the joint in one place during the workout. As the patient progresses the workouts will increase in intensity and become more challenging. More exercises that are designed to work on balance will be introduced. Balance workouts will be used to make muscles respond quickly without even thinking about it.
These workouts are a form of exercise called neuromuscular training. The idea behind these workouts are when in physical activity whether its sports or work and the body needs to suddenly stop or cut the muscles need to react with just the right amount of speed, control and direction. This skill is extra important for those rehabbing back for sport related activities. When full knee movement is back, the knee isn’t swelling and the muscle strength in the repaired leg is improving, the patient will be allowed to slowly start getting back into work or sport activities. This will likely be around six months out of surgery (Pizzari 204-05).
Conclusion
The ACL is an essential part of the knee for the body as a whole. The functions it preforms help people in everyday life with things people may not even realize. As seen above it can be a devastating injury, yet thanks to modern medicine and technology we have learned to overcome this type of injury and come back better then before in some cases. The rehabilitation process involved after an ACL surgery can seem strenuous and at times exhausting but it is a key part of the recovery, without this the body would be unable to preform normal functions even with the new ACL. It helps rebuild confidence as well as strength to get back to the things people love. An ACL tear can be a career ending injury only if one lets it be, If someone has the desire to come back better then before and is willing to go through the process they will go back to regular activities well under a year.
Recommendations
After an ACL tear its key to identify the persons intentions after the injury. If the patient wants to come back from the injury and do the same activities as before, it is highly recommended that surgery take place. The benefit of doing this as soon as possible is it will protect the knee from further injuries. The following are usual recommendations by a doctor after an ACL tear and or surgery;
Get the surgery to prevent further damage to knee.
Rehab the injury for a full six months after surgery.
Wear knee brace until the doctor says otherwise to prevent another tear.
Trust the process and have faith in your recovery, do not be hesitant once cleared.
Works Cited
"Anterior Cruciate Ligament (ACL) Injuries-OrthoInfo - AAOS." Anterior Cruciate Ligament (ACL) Injuries-OrthoInfo - AAOS.
N.p., n.d. Web. 23 Apr. 2015.
Duffee, Andrew R., Timothy E. Hewett, and Christopher C. Kaeding. Revision ACL
Reconstruction: Indications and Technique. New York: Springer, 2013. OhioLINK Institution Selection. Web. 22 Apr. 2015.
Ferretti, Andrea, et al. "Revision ACL Reconstruction Using Contralateral Hamstrings."
Knee Surgery, Sports Traumatology, Arthroscopy 21.3 (2013): 690-695. Academic Search Complete. Web. 21 Apr. 2015.
Grodski, Mark, and Ray Marks. "Exercises Following Anterior Cruciate Ligament
Reconstructive Surgery: Biomechanical Considerations And Efficacy Of Current Approaches." Research In Sports Medicine 16.2 (2008): 75-96. Academic Search Complete. Web. 21 Apr. 2015.
Hagino, Tetsuo, et al. "Complications After Arthroscopic Knee Surgery." Archives Of Orthopaedic & Trauma Surgery 134.11 (2014): 1561-1564. Academic Search Complete. Web. 21 Apr. 2015.
"Johns Hopkins Sports Medicine Patient Guide to ACL Reconstruction." John Hopkins
Medicine. N.p., n.d. Web. 25 Apr. 2015. (images)
"Knee Ligament Surgery." Mayo Clinic Health Letter 27.3 (2009): 7. Academic Search Complete. Web. 21 Apr.
2015.
McKeon, Brian P., James V. Bono, and John C. Richmond. Knee Arthroscopy. New York, NY: Springer, 2009. Print. (book)
Pizzari, Tania, et al. "Adherence To Rehabilitation After Anterior Cruciate Ligament
Reconstructivesurgery: Implications For Outcome." Journal Of Sport Rehabilitation 14.3 (2005): 201. Academic Search Complete. Web. 21 Apr. 2015.
Schindler, Oliver. "Surgery For Anterior Cruciate Ligament Deficiency: A Historical
Perspective." Knee Surgery, Sports Traumatology, Arthroscopy 20.1 (2012): 5-47. Academic Search Complete. Web. 21 Apr. 2015.
Shalvoy, Robert M. "Predicting Success In ACL Reconstruction." Rhode Island Medical Journal 97.11 (2014): 29-31. Academic Search Complete. Web. 21 Apr. 2015.
"You 've Torn Your ACL. Now What?." Harvard Health Letter 36.1 (2010): 4-5. Academic Search Complete. Web. 21 Apr. 2015.
Background
One of the most common injuries to the knee involves the anterior cruciate ligament; also known as the ACL. The knee is set up as a central point where three bones meet together forming the knee itself. These bones are the femur (thigh bone), shinbone (tibia) and the kneecap (patella). All of which are connected to other bones by ligaments. The four primary ligaments in the knee are the LCL (lateral collateral ligament), PCL (posterior cruciate ligament), MCL (medial collateral ligament) and the ACL.
Each ligament acts like a rope to anchor each bone together and the entire knee stable. These four ligaments are divided into two categories; collateral ligaments and cruciate ligaments. The collateral ligaments are found …show more content…
on the sides of the knee, the medial ligaments are located on the inside of the knee and the lateral ligaments are on the outside. This prevents the knee from going out when making a sideways movement. Cruciate ligaments are found inside the knee, they cross paths making an “X” shape with the ACL in front of the PCL. The purposes of these are to stop the knee from going to far forward or back and buckling. Despite all of these having a huge role in protecting the knee the ACL takes the crown, without and ACL the tibia would slide out in front of the femur and it also provides rotational stability.
Purpose
The idea behind this paper is to identify the cause of tearing an ACL and how to properly recover and get back to normal activities. Multiple things can occur that will cause the ACL to partially tear and even completely tear. Changing direction rapidly, stopping suddenly, slowing down while running, landing awkwardly after a jump and a direct hit to the knee. Symptoms may include tenderness to the touch, a loss range of motion, and discomfort while walking. After a tear the patient must then decide whether or not to proceed with surgery. Regardless of either decision physical therapy is recommended, if the patient chooses to precede with surgery the discussion on which surgery to do will be begin. There are multiple operations that are done to repair a torn ACL. All of which will create a new graft whether or not the graft is from the patient or a donor. The options include a graft made from the hamstring, patellar tendon, or allograft. As stated before, these can all come from the patient or a donor.
Scope
The focus of this paper will be covering the rehabilitation behind an ACL tear after the surgery. Looking in depth to the different strategies and techniques used to rehab the leg back in the most effective manor.
Discussion
Cause for Injury
An injury to the ACL can occur in a variety of fashions, in noncontact injuries the tear usually occurs when cutting, making a sudden change of direction as well as stopping suddenly and landing from a jump. When any of these instances occur the injured knee will hyperextend while it pivots at the same time putting a lot of stress onto the ACL, which will cause it to either stretch and or tear (Shalvoy 29). In contact sports the leg where the injury occurs is in most cases planted in the ground when contact is made causing hyperextension. The most common sports in which this takes place are, football, basketball, soccer and skiing.
Signs of a torn ACL
In a situation where any of the above occurrences take place the patient can in most cases hear a loud pop sound when the ligament tears. According to doctor Robert Shalvoy, it is not uncommon for people near the action to also hear the pop, as it is very loud and noticeable. Initial pain is common and swelling will begin within and hour or two after the injury. The doctor evaluating will some times ask for the knee to be drained before making a diagnosis, if the fluid contains blood it is likely the ligament was torn. In some cases immediately after the tear, when the trainer or doctor evaluating the injury does a variety of test to check the stability of the knee, it is possible the knee will seem stable because of muscle guarding. Muscle guarding occurs after sustaining an injury, the body has a natural reflex to tense up the muscles around that area to create a brace or support for the injury, because of this the on field test aren’t always affective or accurate (Shalvoy 30). The test preformed shortly after an injury include the Lachman test, the pivot-shift test, and the anterior drawer test. All of these tests put the leg and knee in different positions while they apply pressure to the joint, any unusual motion or unexpected movements of the tibia relative to the femur is a potential sign of a damaged ligament.
Confirming the Injury
The injury its self is all speculation until an official MRI is taken which is the most accurate form of checking for torn ligaments aside from going into the knee through surgery. Once the injury is confirmed as an ACL tear there are two ways to go about recovering. The nonsurgical treatment for an ACL injury focuses on reducing swelling and pain first. The best way to do this is with rest and pain medications such as the standard Tylenol, other treatments for swelling include ice and electric stimulation. Many patients will start physical therapy after the swelling is reduced and movement in the knee starts to increase.
The workouts in PT are designed to help regain normal function of joints and muscles; other exercises will focus on range of motion in order to regain full range of motion in the knee. As physical therapy progresses and strength increases the workouts will progress into more specific movements to help improve the legs stability once again. A brace is recommended and will usually be custom made to ensure a snug fit. The brace is designed to improve stability in the knee and or act as the ACL if injured. Although effective the brace does not ensure that no further damage will occur to the knee ( You’ve torn your ACL. Now what? 5). By not having surgery on an ACL tear other knee injuries are common because of addition stress put on to tendons and ligaments, early knee arthritis also is a side affect.
Surgery
Depending on personal goals post injury as well as the results of physical therapy, surgery will often be recommended to repair the torn ligament. All doctors will suggest regardless of having surgery or not, that one will do several weeks of physical therapy in order to reduce swelling and make the surgery easier. The purpose of this surgery is to keep the tibia from adjusting or moving underneath the femur bone. There are multiple types of surgery for the ACL, which are the following, patellar tendon graft, hamstring tendon graft and an allograft (Knee Ligament Surgery 7). All of these have their pros and cons to each one. Each one of these surgeries can be done arthroscopically, which is a type of surgery done with an arthroscope. Although incisions around the knee are still required, they are not nearly as large nor is the surgeon required to open the joint by doing this. The arthroscope allows the surgeon to have “eyes” in the knee to see while preforming the surgery.
Patellar Tendon
The patellar tendon is a thick band stretching over the kneecap starting at the bottom of the patella and attaches just below the knee to a bumpy bone on the front of the tibia.
Many surgeons prefer to use the patellar tendon while reconstructing the ACL because of its strength and speedy recovery time. It also is easy to make a graft from a patellar tendon because it’s easy to reach. When creating the graft the surgeon removes a portion from the middle of the patella tendon as well as parts of the bone where the patella connected into the tibia and patella. This bone is then used as an anchor when making this graft into the new ACL. A bone drill will create two holes, one in the femur and one into the tibia where the bone from the graft will be put into position there. Two screws are used to hold the bone plugs in place completing the surgery once the new graft is stretched into place (Stener …show more content…
1173).
Hamstring Tendon
Another popular procedure used my many surgeons is that of using a graft of the hamstring tendon. The graft is pulled from part of the hamstring that attaches to the tibia just below the knee joint. The hamstring is a long strong muscle running down the back of the thigh. The most common portion of the hamstring used is called the semitendinosus, this is a tendon that runs along the inside part of the knee and thigh. Also used is the gracilis tendon, this is a strong tendon constructed like a rope with three to four intertwining strands. The surgeon will conjoin the two of these to create one strong band (Ferretti 691). The strength of each hamstring graft is dependent on the patient on which the graft is made from. Similar to the surgery using a patellar tendon two holes are drilled in the tibia and the femur where the graft will be anchored into using screws or staples.
Allograft Reconstruction
Various other materials can also be used to replace a torn ACL. In the case where the best option is to do an allograft reconstruction the surgeon has an option of using tissue from someone else. The tissue is taken from donors or organs when they have passed. It is then sent into a tissue bank where it is cleaned and stored in a freezer until needed. At the time of a surgery the surgeon can call the tissue in for use, the tissue of use is at the choice of the surgeon operating. The allograft can come from the tibialis tendon, patellar tendon, hamstring tendon or even the Achilles tendon (Schindler 34). In this type of surgery the patellar tendon is commonly used because the bone stays attached to the graft, which creates a good anchor that bonds easier with the new body. An allograft is very effective and even can be a quicker recovery since there is no other need to cut into the knee or leg to get a graft from that body.
Complications after surgery
As with any operation there is always risk of complications during or after the surgery. Common problems include, anesthesia complications, thrombophlebitis, infection, problems with the graft and problem at the donor site. Almost all surgeries require some use of anesthesia, problems with anesthesia occur when the patient has an unusual reaction to the drug where the body may have an allergic reaction causing complications.
Blood clots, also known as thrombophlebitis can happen after any surgery but is more common in operations on the hip, pelvis or knee. The clots form in large veins running through the leg causing swelling and pain. The major danger associated with blood clots is the possibility of the clot detaching and traveling up towards ones lungs where the pass ways are much smaller which allow the blockage to be extremely severe causing blood to be cut of to a portion of the lung. To prevent this doctors use two methods, one is by using pressure stockings another is giving patients medication that thins the blood to prevent blood clots (Hagino 1561-62).
Infections can also be an issue but is easily treated with medication. Problems with the graft occur because once the graft is placed the body has to create a new blood network to the graft site. If the body rejects the graft no blood will flow to the graft and it will die causing it to tear again. This will require a second surgery if that occurs. Issues at the donor sight can occur when the graft is taken out of the hamstring from the patients themselves. When this takes place the body will try to compensate for the tendon that was removed by replacing it with scar tissue, yet this scare tissue is weaker then the original tendon which can cause a tear in the hamstring when training heavily (Hagino 1563).
Post Surgery
After surgery is complete and the patient is allowed to return home; which is almost always the same day of the surgery its self, the patient is told to ice heavily as well as elevate the knee. It isn’t long before therapy will begin, 2-3 days out of surgery is a standard start up time in order to start the recovery process. According to Mark Grodski, the longer the wait to start physical therapy the more muscle dystrophy; an occurrence that takes place after surgery when the leg isn’t being used causing muscle to be lost, will take place. A brace will be given to the patient in order to keep the knee straight until the doctor feels the patient has progressed enough to begin adjusting the brace to allow the knee to bend. Crutches are required in order to keep weight off of the knee for up to 4 weeks until the knee can bare weight while walking (Grodski 79).
Rehabilitation
Once settled the patient will soon after begin physical therapy, the initial treatments will be designed to control pain and swelling from the surgery. Doctor Tania Pizzari says “The first goal is to have full extension in the knee as quickly as possible”. In order to achieve this physical therapist will choose workouts to help get thigh muscles to fire again. In the first six weeks after surgery patients are warned not to over work the hamstring, to prevent this many of the hamstring workouts are isometric which keep the joint in one place during the workout. As the patient progresses the workouts will increase in intensity and become more challenging. More exercises that are designed to work on balance will be introduced. Balance workouts will be used to make muscles respond quickly without even thinking about it.
These workouts are a form of exercise called neuromuscular training. The idea behind these workouts are when in physical activity whether its sports or work and the body needs to suddenly stop or cut the muscles need to react with just the right amount of speed, control and direction. This skill is extra important for those rehabbing back for sport related activities. When full knee movement is back, the knee isn’t swelling and the muscle strength in the repaired leg is improving, the patient will be allowed to slowly start getting back into work or sport activities. This will likely be around six months out of surgery (Pizzari 204-05).
Conclusion
The ACL is an essential part of the knee for the body as a whole. The functions it preforms help people in everyday life with things people may not even realize. As seen above it can be a devastating injury, yet thanks to modern medicine and technology we have learned to overcome this type of injury and come back better then before in some cases. The rehabilitation process involved after an ACL surgery can seem strenuous and at times exhausting but it is a key part of the recovery, without this the body would be unable to preform normal functions even with the new ACL. It helps rebuild confidence as well as strength to get back to the things people love. An ACL tear can be a career ending injury only if one lets it be, If someone has the desire to come back better then before and is willing to go through the process they will go back to regular activities well under a year.
Recommendations
After an ACL tear its key to identify the persons intentions after the injury. If the patient wants to come back from the injury and do the same activities as before, it is highly recommended that surgery take place. The benefit of doing this as soon as possible is it will protect the knee from further injuries. The following are usual recommendations by a doctor after an ACL tear and or surgery;
Get the surgery to prevent further damage to knee.
Rehab the injury for a full six months after surgery.
Wear knee brace until the doctor says otherwise to prevent another tear.
Trust the process and have faith in your recovery, do not be hesitant once cleared.
Works Cited
"Anterior Cruciate Ligament (ACL) Injuries-OrthoInfo - AAOS." Anterior Cruciate Ligament (ACL) Injuries-OrthoInfo - AAOS.
N.p., n.d. Web. 23 Apr. 2015.
Duffee, Andrew R., Timothy E. Hewett, and Christopher C. Kaeding. Revision ACL
Reconstruction: Indications and Technique. New York: Springer, 2013. OhioLINK Institution Selection. Web. 22 Apr. 2015.
Ferretti, Andrea, et al. "Revision ACL Reconstruction Using Contralateral Hamstrings."
Knee Surgery, Sports Traumatology, Arthroscopy 21.3 (2013): 690-695. Academic Search Complete. Web. 21 Apr. 2015.
Grodski, Mark, and Ray Marks. "Exercises Following Anterior Cruciate Ligament
Reconstructive Surgery: Biomechanical Considerations And Efficacy Of Current Approaches." Research In Sports Medicine 16.2 (2008): 75-96. Academic Search Complete. Web. 21 Apr. 2015.
Hagino, Tetsuo, et al. "Complications After Arthroscopic Knee Surgery." Archives Of Orthopaedic & Trauma Surgery 134.11 (2014): 1561-1564. Academic Search Complete. Web. 21 Apr. 2015.
"Johns Hopkins Sports Medicine Patient Guide to ACL Reconstruction." John Hopkins
Medicine. N.p., n.d. Web. 25 Apr. 2015. (images)
"Knee Ligament Surgery." Mayo Clinic Health Letter 27.3 (2009): 7. Academic Search Complete. Web. 21 Apr.
2015.
McKeon, Brian P., James V. Bono, and John C. Richmond. Knee Arthroscopy. New York, NY: Springer, 2009. Print. (book)
Pizzari, Tania, et al. "Adherence To Rehabilitation After Anterior Cruciate Ligament
Reconstructivesurgery: Implications For Outcome." Journal Of Sport Rehabilitation 14.3 (2005): 201. Academic Search Complete. Web. 21 Apr. 2015.
Schindler, Oliver. "Surgery For Anterior Cruciate Ligament Deficiency: A Historical
Perspective." Knee Surgery, Sports Traumatology, Arthroscopy 20.1 (2012): 5-47. Academic Search Complete. Web. 21 Apr. 2015.
Shalvoy, Robert M. "Predicting Success In ACL Reconstruction." Rhode Island Medical Journal 97.11 (2014): 29-31. Academic Search Complete. Web. 21 Apr. 2015.
"You 've Torn Your ACL. Now What?." Harvard Health Letter 36.1 (2010): 4-5. Academic Search Complete. Web. 21 Apr. 2015.