Health Care

By Rich James

One of the most common problems involving the knee joint is an anterior cruciate ligament tear. The anterior cruciate ligament (also called the ACL) is one of four ligaments that are critical to the stability of the knee joint. A ligament is made of tough fibrous material and functions to control excessive motion by limiting joint mobility. Of the four major ligaments of the knee, the ACL injury is the most common knee ligament injury.

You have some decisions to make about how to best treat your torn anterior cruciate ligament (ACL). One treatment choice isn't right for everyone. Your decision will be based on:

· The specific nature of your ACL injury
· How your ACL injury is affecting your lifestyle
· How your ACL injury is affecting the types of activities you participate in

How do you evaluate an ACL injury?
If your child's knee suddenly swells after an accident or injury, she may have a torn ACL or another serious knee problem.To help protect your child from more injuries that could hurt her growing bones and joints, it is important to get a thorough evaluation and proper treatment.
When you and your child come to our clinic, we will ask what happened before her knee began to swell and hurt. Next, we will examine your child's knee. To doctors trained in sports medicine, knees with ACL tears often feel loose.

Symptoms
Symptoms of a severe and sudden (acute) anterior cruciate ligament (ACL) injury include:

· Feeling or hearing a "pop" in the knee at the time of injury.
· Sudden instability in the knee (the knee feels wobbly, buckles or gives out) after a jump or change in direction or after a direct blow to the side of the knee.
· Pain on the outside and back of the knee.
· Knee swelling within the first few hours of the injury. This may be a sign of bleeding inside the joint (hemarthrosis). Swelling that occurs suddenly is usually a sign of a serious knee injury.
· Limited knee movement because of swelling and/or pain.

Causes
Most ACL injuries happen during sports and fitness activities. The ligament may tear when you slow down suddenly to change direction or pivot with your foot firmly planted, twisting or overextending your knee. Sports that involve running, turning sharply, pivoting and jumping - especially basketball, soccer and volleyball - put the knee at risk. The ACL can also tear when the tibia is pushed forward below the femur, such as during a fall in downhill skiing. A football tackle or accident also can cause an ACL injury.

Prevention:
Use proper techniques when playing sports or exercising. Several women's collegiate sports programs have reduced ACL tears through a training program that teaches athletes how to minimize the stress they place on their ACL.

Although the issue is controversial, the use of knee braces during aggressive athletic activity, such as football, has not been shown to decrease the incidence of knee injuries and may give the player a false sense of security.