ACL or Anterior Cruciate Ligament retear is fortunately rare. However, we come across the retears on regular basis as a tertiary centre for ligament reconstructions. Retear can be either due to a new episode of an acute injury or alternatovely due to repetitive strain over a period of time.
Why & how does it happen?
ACL retear can occur due to a further injury with significant enough twisting of the knee with foot planted. This may happen and would be overwhelming injury for the native ACL as well anyway. Alternatively, it can be due to poor surgical technique and tunnel placements which puts the grafts at risk. Third reason being incomplete rehabilitation and poor refining of the landing technique.
Who gets this injury?
We see this typically in sporting population such as footballers, basketball players, cricketers, badminton etc particularly on early return to sports with inadequate rehabilitation.
Instability Swelling Limited range of movement initially Occasional locking (bucket handle tears)
Instability
Limited range of movement initially
Occasional locking (bucket handle tears)
Natural History (Progression of disease in the absence of treatment)
The ACL retear will gradually become pain-free over a period of few weeks. However, as ACL cannot heal naturally, the instability and pain on sudden change of direction of twisting movements of the leg persists indefinitely. That can over a period of time lead to further soft tissue injuries (meniscus and cartilage) in the joint and arthritis at the earlier age than anticipated.
Sudden pain while sprinting. It feels as if you have been suddenly hit by a heavy stick in the calf area. Sudden loss of power. difficulty walking.
Sudden pain while sprinting. It feels as if you have been suddenly hit by a heavy stick in the calf area.
Sudden loss of power.
difficulty walking.
When to seek medical help?
A thorough assessment by an expert Arthroscopy Surgeon and MRI scan (preferably 3 Tesla imaging) are necessary to analyze the extent of injury.
What happens to ACL if no treatment is undertaken?
ACL retear along with other joint problems such as cartilage loss and meniscal tears can hasten the onset of arthritis of the joint. Stable joint with functioning ACL is desirable to minimise risk of further wear and tear and injuries.