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ACL Injury- Do I need a surgery?

Updated: Apr 13, 2020

The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments in the human knee. The function of the ACL ligament is to resist anterior translation and medial rotation of the tibia, in relation to the femur. In a more simple explanation the ACL stops the knee from hyper extend. Every year about 3% of amateur athletes and up to 15% of elite athletes injure their ACL.

ACL injury appear to be the greatest in athletes who are between 15-40 years of age. The majority the injuries occur while playing agility sports, and the most often reported sports are basketball, soccer, skiing, and football. An estimated 70% of the injuries are sustained through non-contact mechanisms, while the remaining 30% result from direct contact.

What are your treatment options? 1. Conservative- physiotherapy (3-8 months) 2. Surgery- ACL reconstruction and rehabilitation (9-12 month).

Research shows that you should start with physiotherapy treatment first even if you are planning to surgery in the future.

A systematic review and meta-analysis comparing anterior cruciate ligament reconstruction versus nonoperative treatment and physiotherapy, advise that people following ACL rupture should receive nonoperative interventions before surgical intervention is considered. In both cases the initial treatment is very important to reduce pain, swelling, muscle weakness and gain full range of motion of the knee. The rehabilitation depends on your return to work or play goals, as well as on how severe the injury was, how extensive the surgery was, and how consistent you are with the rehabilitation program.

Only 35%-55% of athletes after ACL reconstruction surgery return to preinjury sport level within two years. Which means you have only about 50% change to go back playing football the way you did before the surgery.

What should you expect to do in your rehabilitation program? Rehabilitation after ACL with or without a surgery should consist of three phases, which are goal based rather than time based and includes: - Reducing pain and swelling - Gaining full range of motion - Electrostimulation - Improving gait pattern - Strengthening and endurance - Proprioceptive and balance - Plyometric exercise - Neuromuscular training - Sport specific training - Return to sport tests

A good physiotherapy rehabilitation program, high motivation and performance will successfully will get you back to active lifestyle and the sport you love.

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