Anterior Cruciate Ligament Injury

Many athletes will experience an anterior cruciate ligament injury this year. These injuries may occur in various ways but can occur with a simple twisting or hyperextension-type injury to the knee as seen often in basketball, tennis, and soccer players. The injury is often associated with a large amount of swelling and obvious loss of function. Usually however, the injury will get better within one to two weeks giving the patient a false sense of security. When the patient returns to various activities they then find that their knee will give way or buckle without warning. These ligaments do not heal with immobilization or time and it may be a lifetime disability if function of the anterior cruciate ligament is not restored. More than half the time when this injury occurs there is also an associated meniscal tear in the knee which may cause other symptoms such as locking or joint line pain.

The anterior cruciate ligament may be reconstructed by using various types of tissue. The most commonly used is a piece of patella tendon with its attachments to bone from the patella(or knee cap the tibia lower leg). This bone tendon bone graft can be used to reconstruct the patient's anterior cruciate ligament. Other tendons within the body such as the hamstring tendons or the quadriceps tendon may also be used. We are also using allografts which are obtained from other patients from tissue banks around the country. Each patient is different and a decision will be made with the patient or a best procedure for their age and activity level. The anterior cruciate ligament reconstructions now are discharged on crutches for approximately two to four weeks depending on what other concomitant injuries such as associated ligament injuries or meniscal injures have to be treated. Rehabilitation is very important and often takes ten to twelve weeks to regain strength and six to twelve months to return to an athlete's pre-injury status. Physical therapy is important in returning a strong stable knee. Poor compliance with rehabilitation may result in loss of full knee motion, prolonged recovery time and difficulty returning to sports. The majority of our patient's undergoing anterior cruciate ligament reconstruction now are able to return to sports participation at a high level within six to twelve months of the original injury.

Douglas Rouse, M.D.
Southern Sports Medicine