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ACL Injuries: Not Just a Knee-Jerk Reaction

by Bradley J. Margo, MD

Each year knee injuries are among the most frequent causes of sports-related injuries in high school athletes. One of the most common injuries is damage to the anterior cruciate ligament, more commonly known as the ACL.

The ACL provides stability to the knee and minimizes stress across the knee joint. The importance of a strong ACL is amplified in athletes, especially in sports like basketball and football, where the ability to accelerate, decelerate, jump and cut is important. Damage to the ACL can cause improper knee function and mobility and can lead to further knee structure damage, including damage to the meniscus and articular cartilage.

Signs You May Be Injured

These types of injuries most frequently occur during a non-contact incident, such as a football player making a sudden cut or change in direction, or a basketball player landing after a jump shot or lay-up. When this happens, athletes will most likely hear a pop, followed by significant swelling of the knee. When an injury does occur, it is critical the athlete receives a complete physical to assess not only the injured ACL, but the other structures around the knee. This includes undergoing imaging studies including an X-Ray and MRI to help assist in making a proper diagnosis and determining what treatment should follow.

Will You Need Surgery

The decision to reconstruct the ACL is not only based on the instability of the knee but also on the individual’s activity level, lifestyle, age and presence of associated injuries. Individuals living a sedentary lifestyle or those willing to modify their activities are considered for surgical alternatives and rehabilitation. Younger individuals and athletes who wish to continue their activities or just remain more active would require surgery. What to Expect in Recovery Once the decision is made to undergo reconstructive surgery, your surgeon will determine which type of replacement ligament, also known as a graft, is best for you. Options include hamstring tendons or the patella tendon from the patient. Another choice would be grafts from a cadaver, which are considered in older surgical candidates. ACL surgery requires athletes to undergo a five to six month rehabilitative process, ensuring the return of range of motion, strength and healing of the graft. While suffering any knee injury can be devastating to a high school athlete, it is important to know that the majority of athletes who require ACL surgery and are dedicated to their rehabilitation come back stronger with less knee instability and improved performance.