ACL Reconstruction

ACL Reconstruction



ACL Reconstruction

Introduction

The knee is one of the most commonly injured joints of the body. Normal function of the knee in both the athletic and the nonathletic population depends on the integrity of the many components that make up this complex joint. Structures made of cartilage in play a key role in maintaining normal function. ACL tear is the most common knee injury. This large ligament in the centre of the knee prevents forward motion of the tibia with respect to the femur. The ligament can tear in one of several ways. If the person's knee struck from the outside (clipping-type injury), the MCL and ACL can tear. Compression on the outside part of the knee can result in lateral bone bruising, and lateral meniscus tear. Another more common mechanism for ACL tear called “indirect.” This occurs when cutting or landing from a jump, and the knee gives out under the stress. The person can hear and feel a “pop” and is unable to continue moving, and the knee swells with blood within an hour. The diagnosis is made, and an MRI scan is obtained to assess all damaged structures.

The anterior cruciate ligament is one of the most frequently torn ligaments of the knee. Complete tear of the ACL is one of the most common injuries in active people. The incidence of knee ligament ruptures, primarily involving the anterior cruciate ligament and the medial collateral ligament, is estimated to be 2 per 1,000 people per year in the general Population. ACL rupture is a disabling knee injury which frequently occurs in young athletes. Anterior cruciate ligaments are frequently injured due to repetition and overuse as well as quick cutting motions that involve acceleration and deceleration. These injuries often upset this balance between mobility and stability of the joint which causes damage to other soft tissues manifested as pain and other morbidity, such as osteoarthritis.

In athletes, most of the time, a torn ACL requires repair to achieve a stable knee. The original ACL tissue cannot successfully be repaired (as yet). Instead, surgeons must create a new ligament with graft material. The graft material can be his/her own tissue (usually a tendon from an area that can afford to lose some tissue) or can come from the tissue bank (tissue harvested from a cadaver). Other decisions include how soon to do the operation after injury, what fixation to use, whether to use braces, and what rehabilitation to follow. The surgical technique is demanding and constantly evolving, with new theories and techniques published every year.

The SMART Balance Master was used for balance function assessment. All subjects were evaluated clinically and submitted to computerized dynamic posturography for the unilateral stance test. The unilateral stance test quantifies postural sway velocity with the patient standing independently on either the right or left foot on the forceplate, with eyes open and with eyes closed. The length of each trial is ten seconds.

RESEARCH QUESTION

What is the effect of knee muscle strength on the stability of knee, following ACL reconstruction in adult males?Discussion

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