ACL Reconstruction cost in India

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What is ACL injury?

An ACL injury is a tear or sprain of the anterior cruciate ligament (ACL) —one of the major ligaments in your knee. ACL injuries most commonly occur during sports that involve sudden stops or changes in direction, jumping and landing — such as soccer, basketball, football and downhill skiing. Many people hear or feel a "pop" in the knee when an ACL injury occurs. Your knee may swell, feel unstable and become too painful to bear weight.

Symptoms

• A loud "pop" or a "popping" sensation in the knee
• Severe pain and inability to continue activity
• Rapid swelling
• Loss of range of motion
• A feeling of instability or "giving way" with weight bearing

Causes

ACL injuries often happen during sports and fitness activities that can put stress on the knee:

• Suddenly slowing down and changing direction (cutting)
• Pivoting with your foot firmly planted
• Landing awkwardly from a jump
• Stopping suddenly
• Receiving a direct blow to the knee or collision, such as a football tackle

When the ligament is damaged, there is usually a partial or complete tear of the tissue. A mild injury may stretch the ligament but leave it intact.

Risk factors

There are a number of factors that increase your risk of an ACL injury, including:

• Being female — possibly due to differences in anatomy, muscle strength and hormonal influences
• Participating in certain sports, such as soccer, football, basketball, gymnastics and downhill skiing
• Poor conditioning
• Wearing footwear that doesn't fit properly
• Using poorly maintained sports equipment, such as ski bindings that aren't adjusted properly
• Playing on artificial turf surfaces

Prevention

Programs to reduce ACL injury include:

• Exercises that strengthen leg muscles, particularly hamstring exercises, to ensure an overall balance in leg muscle strength
• Exercises to strengthen the core, including the hips, pelvis and lower abdomen
• Training and exercise emphasizing proper technique and knee position when jumping and landing from jumps
• Training to improve technique when performing pivoting and cutting movements

Training to strengthen muscles of the legs hips and core as well as training to improve jumping and landing techniques may help to reduce the higher ACL injury risk associated with women athletes.

Diagnosis

Often the diagnosis can be made on the basis of the physical exam alone, but you may need tests to rule out other causes and to determine the severity of the injury. These tests may include:

• X-rays. X-rays may be needed to rule out a bone fracture. However, X-rays don't show soft tissues, such as ligaments and tendons.
• Magnetic resonance imaging (MRI). An MRI uses radio waves and a strong magnetic field to create images of both hard and soft tissues in your body. An MRI can show the extent of an ACL injury and signs of damage to other tissues in the knee, including the cartilage.
• Ultrasound. Using sound waves to visualize internal structures, ultrasound may be used to check for injuries in the ligaments, tendons and muscles of the knee.

Treatment

Prompt first-aid care can reduce pain and swelling immediately after an injury to your knee. Follow the R.I.C.E. model of self-care at home:

• Rest. General rest is necessary for healing and limits weight bearing on your knee.
• Ice. When you're awake, try to ice your knee at least every two hours for 20 minutes at a time.
• Compression. Wrap an elastic bandage or compression wrap around your knee.
• Elevation. Lie down with your knee propped up on pillows.

Surgery

Your doctor may recommend surgery if:

• You're an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting
• More than one ligament or the meniscus in your knee is also injured
• The injury is causing your knee to buckle during everyday activities

During ACL reconstruction, the surgeon removes the damaged ligament and replaces it with a segment of tendon tissue similar to a ligament that connects muscle to bone. This replacement tissue is called a graft. Your surgeon will use a piece of tendon from another part of your knee or a tendon from a deceased donor.

After surgery you'll resume another course of rehabilitative therapy. Successful ACL reconstruction paired with rigorous rehabilitation can usually restore stability and function to your knee.

There's no set time frame for athletes to return to play. Recent research indicates that up to one-third of athletes sustain another tear in the same or opposite knee within two years. A longer recovery period may reduce the risk of reinjury.

In general, it takes as long as a year or more before athletes can safely return to play. Doctors and physical therapists will perform tests to gauge your knee's stability, strength, function and readiness to return to sports activities at various intervals during your rehabilitation. It's important to ensure that strength, stability and movement patterns are optimized before you return to an activity with a risk for ACL injury.

Frequently asked question

Q. How is avulsion fracture of the knee treated?

Treatment of an avulsion fracture typically includes resting and icing the affected area, followed by controlled exercises that help restore range of motion, improve muscle strength and promote bone healing. Most avulsion fractures heal very well without surgical intervention.

Q. What is worse ACL or PCL tear?

The pain from an ACL tear usually will be more severe than that of a PCL tear. There also may be significant (or total) loss of range of motion of the knee.

Q. What happens if a torn ACL is not repaired?

If nothing is done, the ACL injury may turn into chronic ACL deficiency. Your knee may become more and more unstable and may give out more often. The abnormal sliding within the knee also can hurt cartilage. It can trap and damage the menisci in the knee and can also lead to early osteoarthritis.

Q. How long does it take to recover from ACL tear without surgery?

The knee joint has lost functionality. The prognosis for a partially torn ACL is good. Physical therapy will likely be required, but rehabilitation and recovery can happen within 3 months without surgical intervention. In some partial tears, surgery may be recommended.

Q. How long does arthroscopic ACL surgery take?

The procedure usually takes less than two hours. It will require an incision to remove a tendon if you are undergoing an autograft, in which a tendon from another part of your body is inserted in your knee.