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Anterior Cruciate Ligament Injury: Causes, Symptoms, Types, Risk Factors, Diagnosis, Treatment, Prevention and Complication

Jul 25, 2023

Anterior Cruciate Ligament Injury: Causes, Symptoms, Types, Risk Factors, Diagnosis, Treatment, Prevention and Complication

The anterior cruciate ligament (ACL) is one of the strong bands of tissue that helps connect thigh bone that is femur to shinbone that is tibia. Any torn or sprain in this ligament leads to ACL Injury.

The most frequent causes of ACL injuries include sports like downhill skiing, basketball, football, and soccer which involve sudden pauses or changes in direction, jumping, and landing.

Numerous victims of ACL injuries describe feeling or hearing a "popping" sensation in their knee. Your knee may become painful to bear weight on, swell, feel unstable, and feel unstable.

Treatment options might range from rest and strengthening exercises to surgery to repair the torn ligament, followed by rehabilitation, depending on the severity of your ACL damage. A successful training program could be helpful.

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Causes Of ACL Injury

Ligaments, which are thick tissue bands, connect one bone to another. The ACL stabilizes your knee joint by joining your thighbone to your shinbone. One of the two ligaments that cross in the middle of your knee is this one.

ACL injuries frequently happen while engaging in physical activities and sports that put the knee under stress:

  • Quickly slowing down and changing direction (cutting)
  • Swiveling while holding a foot firmly in place
  • Landing awkwardly after a leap
  • Coming to a sudden stop
  • Taking a direct knee strike, or running into something, like during a football tackle.
  • When a ligament is injured, the tissue often tears completely or partially. A mild injury may stretch the ligament but not necessarily break it.

Symptoms Of ACL Injury

ACL damage symptoms and signs typically include:

  • Loud popping in the knee
  • Severe pain and difficulty to continue with the activity
  • Rapid swelling
  • Reduction in motion
  • A sensation of trembling when bearing weight

Types Of ACL Injury

The severity of your ligament damage may be assessed by your doctor using a scale of one to three, with three being the most serious:

  • Grade 1: The ligament is stretched, yet it still stabilises your knee joint.
  • Grade 2: The ligament has been stretched out and loosened. It has some rips in it. (This level is rare.)
  • Grade 3: The ligament has split in half, causing a rupture. This wound is really dangerous. 

Together with ACL injuries, collateral ligaments, the joint capsule, the articular cartilage, or the menisci (cartilage pads) are frequently hurt.

Risk Factors Of ACL Injury

Your likelihood of suffering an ACL injury is affected by a number of variables, including:

  • Being a woman, potentially as a result of anatomical, muscular, and hormonal differences
  • Taking part in particular sports, such as basketball, gymnastics, football, soccer, and downhill skiing
  • Poorly maintained
  • Using improper movement patterns, such as squatting with the knees turned inward
  • Wearing shoes that don't fit right
  • Using sports equipment that hasn't been properly maintained, like improperly fitted ski bindings
  • Playing on synthetic grass.

Diagnosis of ACL Injury

During the physical, your doctor will inspect your knee and check the swelling and pain in both your injured and healthy knees. The diagnosis may usually be made by performing a physical exam, but additional testing might be required to rule out other causes and determine the severity of the damage. These examinations could include:

  • X-rays. X-rays can help to  rule out a fracture of bone. However, X-rays do not show soft tissues like ligaments and tendons.
  • Magnetic resonance imaging (MRI). An MRI creates images of the soft and hard tissues in your body using radio waves and a strong magnetic field. The extent of an ACL tear as well as any signs of cartilage loss and other knee tissue damage can all be seen on an MRI.
  • Ultrasound. The ligaments, tendons, and muscles in the knee can be examined for damage using ultrasound, which uses sound waves to see within the body.

Treatment Of ACL Injury

After a knee injury, first aid care can result in immediate pain reduction and a decrease in edema. Use the R.I.C.E. self-care paradigm at home:

  • Rest. Resting generally promotes recovery and prevents stress on your knee from carrying weight.
  • Ice. Try to ice your knee while you are awake at least once every two hours for 20 minutes at a time.
  • Compression. Your knee should be wrapped in a compression or elastic bandage.
  • Elevation. Your knee should be raised on cushions as you lie down.


Rehabilitative therapy is the first step in medical treatment for an ACL tear which can  last for  several weeks. A physical therapist will teach you exercises that you can perform at home or under constant supervision.

You could also use crutches for a while to prevent placing weight on your knee while wearing a brace to keep it stable.

Rehabilitation aims to lessen soreness and swelling, regain full range of motion in your knee, and build up your muscles.This kind of physical therapy may be successful in treating an ACL injury in those who are moderately active, engage in leisure activities and exercise at a moderate intensity, or play sports that are easier on the knees.

Surgery Your physician might advise surgery if:

You desire to continue competing in your sport because you are an athlete, especially if it involves jumping, cutting, or rotating. Your knee also has many torn ligaments or damaged fibrous cartilage.

Your knee is buckling as a result of the injury when performing daily tasks.

In an ACL repair, the surgeon removes the damaged ligament and replaces it with a section of tendon, which is tissue that binds muscle to bone and functions similarly to a ligament. Graft is the name given to this substitute tissue.

Your surgeon will utilise a tendon from a deceased donor or a segment of tendon from another area of your knee.

You'll continue with another round of rehabilitation therapy after surgery. Usually, a successful ACL restoration and strict therapy can give your knee the stability and functionality it once had.

Athletes can return to competition at any moment. According to recent studies, up to one-third of athletes get another knee rupture, either in the same knee or the opposite knee, within two years.

A longer recovery time may lower the possibility of reinjury.

Athletes typically have to wait up to a year or longer before they may safely return to play. At various points during your rehabilitation, doctors and physical therapists will conduct tests to determine the stability, strength, function, and readiness of your knee to return to athletic activities. Before returning to an activity where there is a chance of injuring your ACL, it's critical to make sure that your strength, stability, and movement patterns are optimised.

Complications Of ACL Injury

ACL injuries enhance a person's risk of getting osteoarthritis in their knees. Even after surgery to repair the ligament, arthritis may still form.

There are numerous factors that may affect the likelihood of developing arthritis, some of which include the severity of the initial injury, the presence of accompanying lesions in the knee joint, or the level of activity after therapy.

Prevention Of ACL Injury

ACL tears in athletes can't always be prevented, but there are a number of conditioning techniques that can lessen the risk of getting one.

If you play football, basketball, or volleyball, you should pay close attention to how you cut that is, take strong, rapid steps to accelerate in a different direction and plant that is, come down on your feet after jumping or hopping.

These cutting and planting motions account for about 70% of all ACL injuries.

Due to the jumping, landing, and spinning that is necessary in these sports, the ACL of the knee is put under a lot of stress, especially by female athletes. When beginning a cut (or other movement), the ACL's ability to endure rotational pressures could be affected.

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