ACL RECONSTRUCTION in FRANCE
The anterior cruciate ligament (ACL) is one of four knee ligaments. There are two collateral ligaments (MCL and LCL) and 2 ligaments called central cross as they intersect in the middle of the knee. The ligaments are stretched from one guy to another bone. They allow joint surfaces remain in contact during movement and thus ensure the stability of the joint. Cruciate ligaments and especially the anterior cruciate ligament provides most of the stability of the knee. Breach of the lateral ligaments, one speaks of mild sprain, but in case of infringement of the anterior cruciate ligament sprain is serious talk, for then the stability of the knee is compromised.
Consequence of the ACL rupture
Rupture of anterior cruciate ligament thus causes a decrease in the stability of the knee. Fortunately, the anterior cruciate ligament is not necessary in everyday life sedentary. It is involved in activities where the legs are involved significantly in particular in gestures of twisting the knee, such as ball games or combat ...
How can we make an ACL sprained?
Several mechanisms may lead to an ACL rupture. Most often, this is a twisted knee during a reception of a jump or during a change of direction while running, the foot still stuck in the ground. The skiing accident during a turn or fall without detaching is also conventional. Other mechanisms exist especially hyperextension of the knee during a shoot in the air for example.
What are the signs to suspect an ACL ruptured ?
The classic triad of ACL rupture is "Cracking - dislocation - immediate swelling. The athlete feels a cracking or tearing sensation in the knee. The dislocation is felt either as a sensation that the knee by the side then back up is that the knee was rotated (torsion). Shortly after injury, the knee began to swell significantly. Walking is difficult or impossible.
Unfortunately, in some cases, these signs do not exist, the knee does not swell barrier example. Pain is not a good sign because in some breaks, it is minimal or absent. That is why a specialist consultation is necessary when knee sprain.
ACL rupture diagnosis
The ACL rupture diagnosis is a clinical diagnosis. The ACL can be compared to a rope that holds the knee. If the cord is intact, the knee is stable, if it is broken, we say the knee is lax (moves abnormally when examined). Thanks to specific tests (Lachman test), the specialist can usually tell if there is a breach or not.
Very often, the diagnosis is focused on MRI, but these images are only a picture of ACL. MRI can only say if ACL presente a lesion or not.
How to treat?
It does exist two treatments : functional treatment and surgical treatment.
1. Functional treatment :
Objective : compensate the absence of an ACL and muscle proprioceptive rehabilitation. That will allow the knee to remain stable. The anterior cruciate ligament is one of the stability of the knee, but other structures will contribute in particular muscles.
Rehabilitation grants will be developed in a hand muscle strength of knee muscles (quadriceps in front and rear hamstring) and secondly, the overall functioning of the knee position (standing, jumping, running) to improve equilibrium and stability of the knee.
- Surgical treatment :
Surgical treatment is to reconstruct the anterior cruciate ligament with an other tendon. The tendon most used is the patellar tendon. Another technique uses the tendons of the crow's feet.
Possible surgery secondary
ACL is not repaired
Do not allow the resumption of all sports
Muscles have to be trained regularly
Repair of the ACL
Allows recovery of all sports
Surgery with operative risks
In case of failure, complex surgery
Who can be operated ?
Fortunately, ACL is not part of the vital organs of the human being. The vast majority of people can live normally without anterior cruciate ligament. For these individuals, the functional treatment is enought.
Patients who need a perfect stability in their lives or because of sports or job should choose surgical treatment. Surgical treatment is indicated when there are significant lesions associated with anterior cruciate ligament rupture causing instability in everyday life.