For athletes and less active patients alike, an ACL injury is one of the most common conditions affecting the knee — causing pain, instability, reduced strength and limited motion. ACL tears are commonly sustained in sports, during which an athlete may pivot or change directions while running. However, any non-athletic activity that forces the knee to move beyond its natural range of motion can put a patient at risk of tearing or injuring the ACL.
While not every ACL injury requires surgery, severe tears are best treated arthroscopically. Used in both the general orthopaedic and sports medicine fields, arthroscopic techniques are reported to enable faster recovery times and reduced post-op discomfort.
Only an orthopaedic surgeon can accurately identify an ACL tear and suggest a treatment option that works for the patient. Dr. Craig C. Greene is a sports medicine specialist, treating patients suffering from knee pain for a variety of reasons, including meniscal tears, ligament tears, and osteoarthritis. To learn more about knee pain treatment at the Baton Rouge Orthopaedic Clinic, schedule an appointment with Dr. Greene at his office on Bluebonnet Boulevard.
As the body’s largest joint, the knees are responsible for bearing the majority of the body’s weight in standing posture, as well as in motion. The knee is comprised of three main bones: the tibia (shinbone), the femur (thighbone), and the patella (kneecap). An additional bone, the fibula, runs parallel to the tibia and gives support to the knee and ankle.
Protective cartilage lines the knee joint, covering the ends of the femur and tibia. This cartilage allows the hinge joint to swing freely without experiencing pain or friction.
Four ligaments connect the bones to provide support and stability, limiting the knee’s range of motion to prevent unnatural movement. The “cruciate” ligaments, including the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), are found on the inside of the knee and connect the femur to the tibia. These ligaments prevent excessive backward and forward motion of the tibia. The “collateral” ligaments are located on the inside and outside of the knee joint, and include the medial collateral ligament (MCL) and the lateral collateral ligament (LCL). These ligaments prevent excessive abduction and adduction of the knee, respectively.
If any of the knee’s components are injured, pain and joint dysfunction may arise. Damage to cartilage may cause bone to rub against bone, leading to pain and eventually osteoarthritis if left untreated. Minor damage to the ligaments may cause pain and instability, while severe tears may cause severe pain, immobility, and significant joint swelling.
Of the four ligaments found in the knee, the ACL is the most commonly damaged. The ACL can be injured in sports that require a significant amount of running; however, any action that causes the knee to be extended beyond its natural range of motion may cause the ACL to tear.
Symptoms of an ACL tear include:
- Loud “pop” sound occurring at the time of the injury
- Feeling that the knee has given out (instability)
- Joint swelling / joint pain
Treating an ACL Tear
Many patients can forego knee surgery and effectively manage their ACL injury through nonsurgical solutions, including activity modification, physical therapy, and rehabilitation. These conservative approaches are appropriate for less severe tears, particularly if the patient is not interested in pursuing athletic activities.
For patients that wish to continue their active lifestyles, or have experienced more severe ACL tears, repair surgery may be the best treatment option. Arthroscopic surgery allows a knee surgeon to perform ACL reconstruction surgery through tiny incisions, making the surgery less invasive than traditional open knee surgery.
Because of knee arthroscopy’s minimally invasive nature, patients can potentially expect benefits including:
- Less noticeable scarring
- Less blood loss during surgery
- Less invasion and trauma to muscles and tissue
- Faster postoperative recovery period
- Shorter hospital stay
- Decreased pain and discomfort after surgery
Arthroscopic ACL Surgery
Surgery to correct a torn ACL is performed with the assistance of a tiny fiber-optic camera called an “arthroscope”. Inserted into the knee through a tiny incision, the device sends real-time images of the inside of the knee to a monitor in the operating room. With the arthroscope providing a view of the knee from within, the surgeon can perform the operation through a second incision.
ACL reconstruction is performed by replacing the torn ligament with a substitute graft made of tendon. The grafts are typically taken from the patellar tendon, hamstring tendon, or quadriceps tendon.
Arthroscopic ACL surgery is typically performed on an outpatient basis. ACL Reconstruction restores the function of the torn ligament, stabilizes the knee, and can potentially allow patients to return to athletic activity.
Post-Op Care and Considerations
Although minimally invasive in nature, knee arthroscopy requires attentive post-op care to avoid re-injury. For up to 2 weeks following the surgery, it will be important to keep the incision area covered, avoiding the corruption of any sutures or stitches. Likewise, crutches or other support methods should be used to prevent undue pressure and weight from being placed on the knee.
Both at-home exercises and physical therapy visits will be arranged for the gradual and attentive recovery of knee function. To start, exercises will focus on regaining flexibility and full knee rotation, while strength training will be added after a few weeks’ time. Before advancing fitness efforts or undertaking other physical activities, medical clearance should be sought in order to avoid any setbacks to recovery.
While the risks associated with knee arthroscopy are minimal, any potential complications should be the focus of immediate medical attention.
ACL Surgery in Baton Rouge, LA
Dr. Craig C. Greene is a fellowship-trained orthopaedic surgeon, specializing in traumatology and sports medicine. Dr. Greene also specializes in arthroscopic surgery, and has treated countless patients for their knee pain and ligament injuries. For more information about treatment at the Baton Rouge Orthopaedic Clinic, schedule an appointment with Dr. Greene to discuss potential treatment options for musculoskeletal pain.