What are anterior cruciate ligaments?
The knee joint has four very strong ligaments. These are the medial collateral ligament, lateral collateral ligament, anterior cruciate ligament and posterior cruciate ligament. The anterior cruciate ligament is a deep ligament inside the knee. The anterior cruciate ligament and the posterior cruciate ligament cross over each other and look like a crucifix hence the name cruciate ligaments. Its function is to stop forward movement of the shin bone (tibia), on the thigh bone (femur). It acts as a stabilising structure, to prevent excessive movement of the knee and to prevent rotation the knee.
How does injury to the anterior cruciate ligament occurs?
Injury to the anterior cruciate ligament occurs when a shearing or twisting movement occurs through the joint. Anterior cruciate ligament damage occurs usually in sport, although any movement that puts a strain on the ligament can cause damage. An example of injury in sport would be to have the foot fixed on the ground fully weight-bearing, with sportsperson attempting to turn. As the foot planted to the ground, the rotational force can go through the knee causing damage to the anterior cruciate ligament. It can also happen in scenarios such as a car crash, where the driver is in a fixed position on the seat, and has a force through the pedals, which then goes through the knee causing a shearing force damaging the anterior cruciate ligament. Many footballers have suffered cruciate ligament damage. The most recent and most memorable individuals are Michael Owen, Alan Shearer, Joe Cole, Michael Essien, Ruud Van Nistelrooy and Paul Gascoigne.
What are the symptoms?
When the injury first occurs, there may be an audible pop or crack, all the feeling of something moving out of place and then back into place again. There may be severe pain following injury, this however does subside fairly quickly. When you try to weight bear, there will be a feeling of instability, or it may feel like the knee will give way when you put weight on it. Thigh injury to the cruciate, there will be swelling around the whole knee so that it resembles a knuckle. There will be swelling of the knee due to bleeding inside of the joint (this is known haemarthrosis) from. The knee will be unable to fully straighten, or fully bend, and this will be due to the amount of swelling that is present. The swelling is there to protect the knee from further damage and help stabilise the knee, however if the swelling persists, it may interfere with the rehabilitation
What should you do?
If you are participating in sport, you need to cease immediately. There will be a lot of swelling around the joint. This is because of bleeding in the joint because of the torn ligament, but also a protective mechanism to prevent further damage. However, too much swelling can cause a delay in dealing and possibly damage tissue. You should perform R.I.C.E to help keep the swelling under control.
Rest — you should limit weight-bearing movements on the knee and cease activity. Crutches may be helpful if you have access to them.
Ice -- Ice packs should be applied to the site of injury to help limit the amount of swelling, but also take away any inflammation that may be occurring.
Compression -- keeping the knee wrapped in a tubular elastic bandage for compression will limit the amount of swelling that may occur and also give you vital support around the knee.
Elevation -- elevating your legs at roughly the same height as your heart will allow fluid to move easier through your leg.
We should try and see your osteopath as soon as possible, who will diagnose accurately, what injury you have done. They will then discuss with you how bad the injury is and what your next step is in terms of your rehabilitation
What shouldn't you do?
We should not continue to participate in any activity or sport. You should rest and avoid any activity that involves applying heat to the knee or causing your body temperature to rise, for example, a hot water bottle. This will increase blood flow through the area, decreasing your body's ability to heal.
Could there be long-term effects?
Unfortunately, injury to the anterior cruciate ligament can take a long time to recover. The ligament cannot heal itself and it was required for effective knee function. Surgery is required to reconstruct the ligament. Tissue from another part of the body may be used to reconstruct the anterior cruciate ligament. The mechanism of injury to the anterior cruciate ligament, other structures may also be injured such as the cartilage between the tibia and femur and/or other ligaments. Due to injury to the structure, this may lead to a greater possibility of getting osteoarthritis of the knee later on in life.
Management
Usually, management of the injury requires corrective surgery to reconstruct the damage ligament. This may be in the form of either a hamstring tendon graft or patellar tendon graft. Following surgery, the knee has to be stabilised and strengthened to help rehabilitate it. Rehabilitation can take up to 6 months to a year.
The knee joint has four very strong ligaments. These are the medial collateral ligament, lateral collateral ligament, anterior cruciate ligament and posterior cruciate ligament. The anterior cruciate ligament is a deep ligament inside the knee. The anterior cruciate ligament and the posterior cruciate ligament cross over each other and look like a crucifix hence the name cruciate ligaments. Its function is to stop forward movement of the shin bone (tibia), on the thigh bone (femur). It acts as a stabilising structure, to prevent excessive movement of the knee and to prevent rotation the knee.
How does injury to the anterior cruciate ligament occurs?
Injury to the anterior cruciate ligament occurs when a shearing or twisting movement occurs through the joint. Anterior cruciate ligament damage occurs usually in sport, although any movement that puts a strain on the ligament can cause damage. An example of injury in sport would be to have the foot fixed on the ground fully weight-bearing, with sportsperson attempting to turn. As the foot planted to the ground, the rotational force can go through the knee causing damage to the anterior cruciate ligament. It can also happen in scenarios such as a car crash, where the driver is in a fixed position on the seat, and has a force through the pedals, which then goes through the knee causing a shearing force damaging the anterior cruciate ligament. Many footballers have suffered cruciate ligament damage. The most recent and most memorable individuals are Michael Owen, Alan Shearer, Joe Cole, Michael Essien, Ruud Van Nistelrooy and Paul Gascoigne.
What are the symptoms?
When the injury first occurs, there may be an audible pop or crack, all the feeling of something moving out of place and then back into place again. There may be severe pain following injury, this however does subside fairly quickly. When you try to weight bear, there will be a feeling of instability, or it may feel like the knee will give way when you put weight on it. Thigh injury to the cruciate, there will be swelling around the whole knee so that it resembles a knuckle. There will be swelling of the knee due to bleeding inside of the joint (this is known haemarthrosis) from. The knee will be unable to fully straighten, or fully bend, and this will be due to the amount of swelling that is present. The swelling is there to protect the knee from further damage and help stabilise the knee, however if the swelling persists, it may interfere with the rehabilitation
What should you do?
If you are participating in sport, you need to cease immediately. There will be a lot of swelling around the joint. This is because of bleeding in the joint because of the torn ligament, but also a protective mechanism to prevent further damage. However, too much swelling can cause a delay in dealing and possibly damage tissue. You should perform R.I.C.E to help keep the swelling under control.
Rest — you should limit weight-bearing movements on the knee and cease activity. Crutches may be helpful if you have access to them.
Ice -- Ice packs should be applied to the site of injury to help limit the amount of swelling, but also take away any inflammation that may be occurring.
Compression -- keeping the knee wrapped in a tubular elastic bandage for compression will limit the amount of swelling that may occur and also give you vital support around the knee.
Elevation -- elevating your legs at roughly the same height as your heart will allow fluid to move easier through your leg.
We should try and see your osteopath as soon as possible, who will diagnose accurately, what injury you have done. They will then discuss with you how bad the injury is and what your next step is in terms of your rehabilitation
What shouldn't you do?
We should not continue to participate in any activity or sport. You should rest and avoid any activity that involves applying heat to the knee or causing your body temperature to rise, for example, a hot water bottle. This will increase blood flow through the area, decreasing your body's ability to heal.
Could there be long-term effects?
Unfortunately, injury to the anterior cruciate ligament can take a long time to recover. The ligament cannot heal itself and it was required for effective knee function. Surgery is required to reconstruct the ligament. Tissue from another part of the body may be used to reconstruct the anterior cruciate ligament. The mechanism of injury to the anterior cruciate ligament, other structures may also be injured such as the cartilage between the tibia and femur and/or other ligaments. Due to injury to the structure, this may lead to a greater possibility of getting osteoarthritis of the knee later on in life.
Management
Usually, management of the injury requires corrective surgery to reconstruct the damage ligament. This may be in the form of either a hamstring tendon graft or patellar tendon graft. Following surgery, the knee has to be stabilised and strengthened to help rehabilitate it. Rehabilitation can take up to 6 months to a year.