Anterior cruciate ligament injury is one of the most common injuries sustained during a knee sprain. It is most often associated with a sports injury and results in knee instability.

Anterior cruciate ligament injury most often occurs during football, basketball or a skiing fall.

An untreated anterior cruciate ligament injury leads to secondary meniscus damage.

Knee instability causes secondary joint degeneration.

Symptoms

Early – after the injury

  • pain
  • swelling
  • an audible crack in the knee
  • inability to bear full weight on the limb after injury
  • a catching sensation in the knee
  • knee locking
  • a feeling of instability in the affected knee

Late symptoms of chronic ACL injury

  • a feeling of instability, the knee giving way or buckling when walking, particularly when running on uneven ground or suddenly changing direction

Diagnostics

  • diagnosis is based on a proper orthopaedic examination, including instability tests that allow a reliable diagnosis with a high degree of probability
  • ultrasound and conventional X-rays are useful additional examinations that often confirm the initial diagnosis
  • MRI provides the best imaging of anterior cruciate ligament injuries, detecting ACL damage with over 90% accuracy and enabling surgical planning

Treatment

  • most patients with anterior cruciate ligament injuries require surgery because of instability in the affected knee
  • arthroscopic reconstruction is the gold standard for anterior cruciate ligament injuries. A new ligament is formed from the patient's own tissue, most commonly the knee flexor tendons, the semitendinosus and gracilis, or the patellar tendon. The graft is fixed in the femur and tibia using appropriate implants.

Postoperative management

  • in most cases, patients can leave hospital on the second or third day after arthroscopic treatment of anterior cruciate ligament injuries
  • patients usually use forearm crutches for four to six weeks to protect the operated knee
  • the operated limb is supported by a knee brace for approximately three weeks
  • thrombosis prevention is required for approximately 30 days after surgery
  • Patients discharged home learn the basic ways to manage postoperative swelling.
  • patients begin an intensive rehabilitation programme on the first day after surgery, individually developed for each patient by our rehabilitation team