ACL injury can be a tear, sprain or complete rupture of the Anterior Cruciate Ligament and it is one of the most common knee injuries. People that are engaged in sports activities such as football, and skiing are at a higher risk of getting an ACL tear. Moreover, more than 70% of ACL injuries are caused by a rapid deceleration in a sports setting. Depending on the severity of the injury, an orthopedic surgeon may suggest surgical or non-surgical treatment.
- Surgical Treatment comprises of the removal of damaged ACL, amassing of a new graft, drilling of tunnels in knee bone and shinbone, placing and fixing the new graft at the original position of the ACL
- Non-surgical Treatment comprises of physiotherapy, ice bags, and anti-inflammatory medicines
How to Know If You Have an ACL Tear/ Injury?
Most common symptom of an ACL tear is a popping sensation in the knee. Other symptoms are:
- Sharp pain around the knee area and inability to walk or run
- Redness and swelling
- Feeling of instability, or feeling that you will fall
- Pain in the knee while weight-bearing
What Causes an ACL Tear/ Injury?
Our knee ligaments are made up of a strong band of tissues that connects one bone to another and aids in stability during movements. An ACL is one of the two types of ligaments that crosses in the middle of the knee, connects to the thigh bone and shinbone and helps stabilize your knee joint. One of the most common cause for an ACL injury is sports and fitness activities, however, other things that lead to an ACL tear are:
- Sudden change in direction and slowing down
- Turning when the foot is firmly planted to the ground
- Wrong landing from a jump
- Directly hurting the knee or falling on the knee
Risk Factors and Prevention
People with an ACL injury/ tear have a higher chance of developing osteoarthritis in the knee, it may also occur even after reconstruction surgery of the injured ligament is performed. However, this risk can be avoided by proper training and exercise, taking physiotherapy and by avoiding sharp movements in day to day activities.
What Type Of Graft Should You Opt For?
It is important to know that if an ACL is completely torn it will not heal back together. The only way of fixing the torn ACL is by completely replacing it with a new graft. The graft used for replacing the ACL can be yours or can be from a donor. The surgery performed to fix the ACL can be an open surgery or an arthroscopic surgery. Moreover, you can also choose which graft to use for the replacement, have a talk with your orthopedic and see what he suggests. However, most basic types of grafts are:
- Hamstring Tendon Graft
Hamstring is a group of muscles on the side of your shin and at the back of your thigh. During the surgery, the surgeon will remove two of the hamstring tendons and will bundle them together to create a new ACL.
- Advantages: Pain is minimum as compared to other grafts because the incision to obtain the graft is smaller
- Disadvantages: Only problem with hamstring tendon is that it takes a lot of time to heal into the place
- Patella Tendon Graft
Patella Tendon is a structure on the front of the knee that connects the kneecap to the shin bone and its width is between 25 to 30mm. During surgery, the surgeon will remove 1/3 of the patellar tendon along with a block of bone that attaches the kneecap and tibia. The chances of getting an infection in the surgery is 0.5%.
- Advantages: Patella tendon is preferable by many surgeons as it closely resembles an ACL and it is a stronger alternative compared to other healing methods
- Disadvantages: After the surgery, the risk of getting a patellar fracture and patellar tendon tear increases. Also, the pain is unbearable while healing and it is also noted that patients feel pain when kneeling or bending the knee even after years of surgery
- Allograft or Donor Tissue
Allograft is commonly used in patients who are undergoing revision of ACL surgery following the failure of previous ACL reconstruction surgery. Moreover, donor tissues are not as strong as the patient’s own tissue, but its strength is sufficient for people who are not planning to participate in high-demand sports.
- Advantages: Surgery takes less time, smaller incisions and less post-operative pain
- Disadvantages: These grafts carry a high risk of disease transmission. Also, the process of graft preparation kills the living cells and decreases the strength of the tissue
Well, it completely depends on the patient to choose whichever graft they prefer and also what their surgeon recommends. Hamstring and Patella tendons are the most preferred type for the surgeons and these grafts exceed the strength of a normal ACL, and more than 90% of the patients will have clinically stable knee following the ACL surgery.
ACL Reconstruction Market
Growing prevalence of sports-related injuries is driving the market growth for the ACL reconstruction Market. For instance, in the U.S. alone, over 90,000 people undergo ACL reconstruction surgery every year. Apart from this, it is also estimated that more than 22% of the reconstruction surgeries fail every year.