Journey to Recovery: A Guide for ACL Injury Patients

Anterior cruciate ligament (ACL) injuries are common among athletes, especially those involved in noncontact sports like basketball and skiing. An ACL injury can be incredibly painful, but it doesn’t have to
sideline you permanently. Here are tips on how to treat an ACL injury, when to return to play and more
from the India’s one of the leading orthopedic and sports surgeons at “The Cruciates – Centre of
Excellence for all Sports Injuries” at Medharbour Hospital, Gurgaon.

What is an ACL injury?

An anterior cruciate ligament (ACL) injury, is an injury in which the ligament in the knee is torn or
injured. This typically occurs when someone pivots from one leg and crashes into something with the
other leg – leading to a tear. This is the most common ligament of knee to be injured. ACL injury can be
partial or complete tear of the ligament. With a complete tear, there will be swelling that forms almost
immediately after the injury and the knee will appear very unstable.

The classic history of an ACL injury

ACL injury usually occurs by noncontact injury while deceleration, jumping, or cutting action. Other mechanisms of injury include external forces applied to the knee. The patient often describes the knee as having been hyperextended or popping out of joint and then reducing. A pop is frequently heard or felt. The patient usually has fallen to the ground and is not immediately able to get up. Resumption of activity usually is not possible, and walking is often difficult. Within a few hours, the knee swells, and aspiration of the joint reveals haemarthrosis.

My personal experience with the ACL

ACL injury is not career ending, patient can return to pre injury level of activity. Returning to sports as before is possible. In fact, the surgeries that have been performed in recent years to treat ACL injuries have advanced so much that return to play can be as quick as 6 months post-surgery. Getting depressed is not a good way to recover from this injury. I have operated plenty of sports persons and they have managed to return back to sports with full strength. One of the best ways is taking your time and deciding what it is you want out of recovery.

The anatomy and physiology of the knee

ACL stands for Anterior Cruciate Ligament. It is one of the four main ligaments of the knee joint. It connects the thigh bone (Femur) to the lower leg bone (tibia), which carries the majority of the body weight. On average, the adult ACL is 30 – 33 mm in length and 9-12 mm in width.

It consists of two bundles:

1) Anteromedial bundle – it becomes tight during knee flexion and prevents anterior (Front)
translation of tibia (shin bone).
2) Posterolateral bundle – it becomes tight during knee extension and is primarily responsible for
rotational stability.

Deciding whether to have surgery or not

Nonoperative treatment

This is viable option for who is willing to make lifestyle changes and avoid the activities that cause recurrent instability. Three factors correlate with the need for surgery: younger age, preinjury hours of sports participation, and amount of instability.

Indications of ACL reconstruction Surgery

Younger, more active patients (reduces the incidence of meniscal or chondral injury)
• Children (activity limitation is not realistic)
• Older active patients (age >40 is not a contraindication if high demand athlete)
• Partial/single bundle tears with clinical and functional instability
• Prior ACL reconstruction failure
• High grade pivot test positive

How do I recover from an ACL injury?

The recovery process is gradual and can span anywhere from six months to one year. In the first few weeks after surgery, most patients do not need crutches but can use a cane, walker or brace for stability. Physiotherapy is usually done from the first day after surgery and continues for about six months post-op. Following surgery, you should take regular guidance from your surgeon until you are completely recovered.

Can I return to competitive sports after an ACL reconstruction?

Yes, ACL injury is not career ending. It is important to focus on rehab and to stick to the basics during post-operative recovery. When a complete tear of the anterior cruciate ligament is suspected, people will typically be recommended to have surgery. If the injury is treated properly, you can achieve preinjury state and get back into sports. Some rehab work may be required after an injury. Working with a physio in your area should help you through this process

Where can I find support while recovering from my surgery?

First contact your sports injury surgeon to understand nature of injury. If you are suffering from low
grade partial ACL tear, you may not need surgery. So, you should take an expert opinion immediately
after injury to decide treatment modality.

One of the best ways you can help yourself recover from an ACL injury is by learning as much as possible
about the injury and what your options are. There are a lot of online resources available, as well as
expert opinion, in forums and articles like this one. You can also find a lot of information about how
people have recovered through social media sites like Facebook or YouTube. You can also send your
reports to us for free expert opinion.

Also Read : The Five Most Common Reasons for Sports Injuries