To view an operative video of ACL Reconstruction, click here.
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The diagnosis can also be made with an arthroscopy. It also demonstrates damage to other structures such as the menisci or articular cartilage. An MRI scan which is a special imaging test is often ordered to confirm the diagnosis in patients where the examination is not conclusive. This can usually be made on history and clinical examination. It is quite common to damage some of these other structures. Careful clinical examination is required to detect damage to the ACL, other ligaments and structures in the knee such as the meniscus or articular cartilage. Most patients will be referred to an orthopaedic surgeon for diagnosis and assessment of the injury.
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Physiotherapy is helpful to reduce swelling and regain motion. An X-ray is necessary to exclude an associated fracture. Crutches and analgesics usually are required. The knee should be treated with ice, elevation and a compressive bandage. Most people cannot continue with their activity and the knee generally swells up within hours. When the ACL ruptures the patient often feels something giving way in the knee or hear a popping sound. It is particularly common in sports such as football, soccer, basketball, netball and skiing but can occur in many other activities. It can also occur after landing from a jump, stopping rapidly or direct contact such as in a tackle. Usually there is a significant injury involving a twisting force to the knee. These injuries may also need to be addressed at the time of surgery. Since the knee ‘dislocates’ when the ligament ruptures there is often damage to other structures in the knee such as bone, cartilage or meniscus. Repeated giving way can lead to damage to other structures of the knee and eventually arthritis.
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When it ruptures it does not heal itself and the knee often becomes unstable or gives way. One of the main functions of the ACL is to provide stability during rotational movements such as turning, twisting and sidestepping. The ACL is required for normal function of the knee. The anterior cruciate ligament prevents the femur moving forward and rotating abnormally on the tibia. It is a strong rope like structure located in the centre of the knee running from the femur to the tibia. The anterior cruciate ligament (ACL) is one of the major stabilising ligaments in the knee.