ACL Injury
- Non-Contact Injuries:
Most ACL injuries happen without direct contact, like when you suddenly change direction or land awkwardly from a jump. According to recent research, these injuries often result from movements that put extra stress on the ACL, such as twisting the knee while landing. - Biomechanical Factors:
Sometimes, ACL injuries are related to how your body moves. For example, poor knee alignment or muscle imbalances can increase the risk. Certain movement patterns and muscle weaknesses make the ACL more vulnerable. Proper training to correct these issues can help reduce your risk of injury. - Women are at more risk of ACL injuries than men.
When you have an ACL injury, most often you will feel a kind of instability in your knee especially while walking downhill or climbing down from stairs.
Diagnosis of ACL is done by a through clinical examination of the knee, and an MRI .
Low grade ACL tears do not require surgery. (Grade1). For grade 2 injury, if during physical examination it reveals that your ACL is incompetent, you might be advised surgery. However, if your ACL is competent and functional, you will be advised exercises and follow-up for few months. If you have a high grade tear partial or complete – you will be advised surgery.
After first few weeks of injury, some people might feel that they no longer have pain or any problem in walking. ACL surgeries are done for Pain. It’s done to improve stability of your knee. An ACL deficient knee is more prone to cartilage and meniscus damage few years down the line. Both these conditions are painful and have long term consequences (early development of osteoarthritis)
You will be at higher risk of meniscal and cartilage injury and subsequent development of osteoarthritis earlier in life.
Currently all evidence proclaims ACL reconstruction to be the best possible surgery. Its an arthroscopic procedure where new ACL is created from a graft which is usually harvested from the same leg.
With strong physiotherapy support, you can start going back to sports within 6 months. But most people will be advised a 1-year program of return to sports. Usually, walking is allowed by first few weeks, and you can resume your office work by 6 weeks. Albeit with a brace. Much of the duration of ACL rehab depends upon if any other concomitant injury was also addressed during the surgery.
The average cost of a basic ACL surgery ranges from 80k-1.2 L. Cost my increase if you have additional injury which needs fixation or newer ACL procedures are performed.
Risk of ACL failure is rare but has been seen around the world. Most ACL fail due to improper graft fixation, implant failure, infections, early return to sports, improper rehab.
You will require a repeat surgery, but extensive radiological investigations are needed for proper planning of the surgery and implant selection. You will have more prolonged recovery.
No ACL usually doesn’t heal by itself. Spontaneous healing has been seen in low grade tears and in younger individuals. But research in this matter is still ongoing. As of now, global consensus lies in replacing the ACL than repairing it.