Q: It seems that you can’t read or listen to the sports news without hearing about someone tearing their ACL. What exactly is it, what happens and why is a person so prone to this injury?
A: The ACL (anterior cruciate ligament) is located in the knee, which is a hinge joint. The knee is designed to bend back and forth to allow for smooth and fluid movement. The weight bearing bones of the knee include the femur (thighbone) and tibia (shinbone). They are kept in alignment with each other by four ligaments in the knee. The collateral ligaments, both medial and lateral, keep the knee from buckling side to side. There are also two ligaments that cross from front to back in the knee. The crossing of these ligaments gives them their name – cruciate. There is a posterior (back) cruciate ligament and anterior (front) cruciate ligament.
Either of these ligaments could potentially be injured but the ACL is the one that seems to be the most vulnerable. The purpose of the ACL is to keep the tibia from shifting forward on the femur when the person suddenly slows or stops their forward motion. An example of this is the soccer, football, or basketball player who plants their foot to change directions. This sudden deceleration causes a huge amount of stress on the ACL. If a pivoting motion or impact from another player is added to that, it can easily be more than this ligament can handle. The momentum of the tibia causes the ligament to tear. As athletes get bigger, stronger and faster, they put increasing demands on this area that some would consider a weak point in the human anatomy. In reality, an intact ACL is not easily torn. It is a very tough and sturdy structure. The vulnerability comes from multiple partial tears that do not heal and cause weakening of the ACL. When the ACL is at a weakened state, it may give way with the stresses previously mentioned.
Statistics show that women are four to six times more likely to have ACL injuries than men. Also, when someone has an ACL reconstructed, they do have a slightly increased risk of reinjury.
When an ACL tears, it does not rip across the ligament but rather, it ruptures. It’s more like an unraveling than being ripped in half. This means that it is not possible to repair an injured ACL; it is reconstructed by a surgeon using tissue harvested from elsewhere in the body or from a donor. This procedure is highly successful but requires a lengthy rehabilitation.
With good effort by the patient, a team including an orthopedic surgeon and physical therapist will, in most cases, be able to get you back to your functional self.
Dave Stoll, PA-C
Orthopedic Care in the office of Jon Orjala, D.O.
Utica Park Clinic – Owasso
10512 N. 110th East Ave., Suite 220
Owasso, OK 74055
918.376.8959
