Sports and knees when rapture turns to rupture
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.