Sports and knees when rap­ture turns to rup­ture

Solihull News - - JULIAN KNIGHT MP -

MANY run­ners, foot­ballers and other sports peo­ple have tales of woe about their knees. You’re at the top of your game one minute, and the next you’re suf­fer­ing one of the most com­mon of sports in­juries: an un­for­tu­nate twist that re­sults in a rup­ture to the an­te­rior ( front) cru­ci­ate lig­a­ment ( ACL).

Mr James Ar­buth­not, Or­thopaedic Con­sul­tant at Spire Park­way Hospi­tal, spe­cialises in get­ting sports peo­ple back on to pitches, slopes and courts.

He says: “The an­te­rior cru­ci­ate lig­a­ment is one of the im­por­tant lig­a­ments that sta­bilise your knee joint. If you have torn ( or ‘ rup­tured’) this lig­a­ment, the knee can col­lapse or give way when you make twist­ing or turn­ing move­ments.”

You can also in­jure other parts of your knee at the same time, such as by tear­ing a car­ti­lage or dam­ag­ing the sur­face of the joint. Signs and symp­toms of an ACL in­jury: Pa­tients will of­ten de­scribe hear­ing a ‘ pop’ or ‘ crack’, fol­lowed by im­me­di­ate pain when the ACL rup­tures. This puts an end to the ac­tiv­ity: the knee will typ­i­cally swell very rapidly, in and around the knee.

Pa­tients will usu­ally go straight to A & E. How­ever, of­ten the knee is dif­fi­cult to as­sess in this acute stage. For an ac­cu­rate di­ag­no­sis the pa­tient will need to be as­sessed fur-

ther, pos­si­bly through an MRI scan, to see if the car­ti­lage is also dam­aged. Since it’s of­ten dif­fi­cult to ex­am­ine a swollen and painful knee soon af­ter the ini­tial in­jury, it’s usual to ar­range for a later MRI scan and phys­io­ther­apy whilst the knee set­tles down. An­te­rior cru­ci­ate lig­a­ment surgery: The ACL re­con­struc­tion surgery is an arthro­scopic pro­ce­dure ( key­hole surgery us­ing a cam­era) in which the dam­aged ACL is re­moved and re­placed with a graft of the pa­tient’s own tis­sue. The op­er­a­tion usu­ally takes 60- 90 min­utes.

Re­cov­ery: Pa­tients usu­ally re­main in hospi­tal for one night and be­gin an out­pa­tient phys­io­ther­apy re­ha­bil­i­ta­tion pro­gramme five days later.

Dur­ing the first three to six months, pa­tients will re­gain a full range of move­ment by fol­low­ing phys­io­ther­apy ex­er­cises to help them to re­turn to normal ac­tiv­ity as soon as pos­si­ble.

The fi­nal phase in­volves spe­cific sport train­ing. This should re­main gen­tle ( for ex­am­ple, avoid tack­ling in foot­ball), to avoid af­fect­ing the re­ha­bil­i­ta­tion.

Af­ter nine months, the re­ha­bil­i­ta­tion is com­plete and pa­tients can re­turn to their cho­sen sport with­out re­stric­tions.

For fur­ther in­for­ma­tion please call 0845 850 1451.

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