ACL Knee Injury & Reconstruction Explained

An Anterior Cruciate Ligament (ACL) tear is a fairly common knee injury in sports that involve changing direction and turning. The ACL lies deep within the knee joint, connecting the thigh bone with the shin bone. The function of the ACL is to prevent excessive forward movement of the shin in relation to the thigh and also to prevent excessive rotation at the knee joint. The ACL plays a major role in maintaining knee joint stability.

An ACL injury can occur in several different ways, most notably by landing from a jump onto a bent knee then twisting, or landing on a knee that is over-extended. In collision sports, direct contact to the knee from opponents can cause an ACL injury, especially if the foot remains fixed to the ground and the rest of the leg is moved in the opposite direction, creating the twisting force. Because of the amount of force that is required to damage the ACL it is not uncommon for other structures within the knee such as the meniscus or medial ligament to also be damaged.

Anatomy of Anterior Cruciate Ligament injury

Knee injuries often occur to the medial structures of the knee, however, a moderate impact against the inner side of the knee joint causes the Lateral Collateral Ligament to rupture. A more violent impact causes the Anterior Cruciate Ligament to also rupture. In severe cases the Posterior Cruciate Ligament ruptures.

ACL injuries have been reported to occur more often now than ever before, which may be due to the increased intensity of sporting activity. In soccer, it is reported that for every 1000 hours of football (soccer) played (training and matches) there are between 4 and 7 ACL injuries. Many high profile professional football players have suffered this injury including Michael Owen, Robert Pires, Xabi Hernandez, Gabriel Heinze, Ruud Van Nistelroy and Zlatan Ibrohimavich..

ACL Knee Injury Signs & Symptoms

At the moment of injury the person may experience a snapping sensation deep within the knee joint. There may also be a "popping" sound and immediate swelling. There will be pain, proportional to the force and degree of damage to other structures within the knee joint. The Medial Collateral Ligament and Menisci ( Cartilage )are often damaged together with the ACL.

In some cases, the person may feel able to continue playing but, as soon as the knee is put under strain during sports activity, the knee joint will become unstable, and weight bearing is difficult. A classic example of this was Paul Gascoigne during the 1991 FA Cup Final, who attempted to continue playing before being stretchered off.

The reason the person is unable to carry on is that the restraining function of the ACL is absent and there is excessive rotation and forward movement of the shin in relation to the thigh, making the knee joint unstable. After a couple of hours the knee joint will become painfully swollen due to what is called a haemarthrosis (bleeding within the joint). This swelling provides a protective function by not allowing the person to use their knee but, if it persists, it can cause complications during the rehab.

ACL Knee Injury Treatment

During the acute stage of the injury (the first 48-72 hours) exact diagnosis is very difficult due to the gross swelling around the joint. The initial goals of physiotherapy treatment are to reduce knee pain and knee swelling. Ice Packs can be applied for periods of twenty minutes every couple of hours (never apply ice directly to the skin as it can cause an ice burn) to relieve pain and reduce bleeding within the tissue. Alongside ice, compression bandages or strapping can also help and sitting with the knee above the hip to help reduce the swelling. The Aircast Knee Cryo/Cuff is the most effective method of providing ice therapy and can be used for the home treatment of knee injuries and knee pain. It can provide continuous ice cold water and compression for 6 hours to significantly reduce knee pain and knee swelling.

Once the initial treatment for the swollen knee has taken effect, the clinical diagnosis may be possible. This may be achieved by the medical personnel performing stress tests on the knee ligaments - the degree of laxity within the joint will allow the clinician to estimate the degree of damage. If there is any doubt, or to confirm the clinical tests, the patient is sent for further investigations. Most commonly an MRI scan is used to ascertain the level of knee injury and the structures involved. In some cases the MRI scan may not give a clear picture of the damage and it may be necessary to survey the joint with an arthroscope. The combination of these findings allows the orthopaedic consultant to build a picture of the extent of the damage.

The treatment of the ACL injury is dependent upon the amount of damage and the subsequent functional impairment, the age of the patient and the level of sporting activity. If the diagnostic investigations reveal only a partial tear of some of the fibres of the ACL, and there is minimal instability, then a conservative approach with a physiotherapist and Knee Brace is usually indicated. This option is also more likely for more sedentary individuals as muscles can be trained to help provide enough stability to fit their lifestyles. In the case of individuals who are involved in a high level of sport where a degree of instability is functionally unacceptable, then ACL reconstruction knee surgery is the surest way to restore normal function.

A Knee Brace can restore a degree of knee joint stability, preventing the feeling that the knee is going to give way'. Together with physiotherapy treatment and muscle strengthening, a Knee Brace can be perfectly sufficient in less active individuals. A knee brace is also helpful in more active individuals, who decide to have ACL reconstruction knee surgery. Modern Knee Braces provide stability without compromising knee movement, so can be used during rehabilitation and on return to sporting activities.

ACL reconstruction knee surgery has evolved beyond recognition since the first ACL repair in 1963. Development has continued since then and the latest surgical technique uses a strip of the patella tendon from the patient's knee as a graft to replace the ACL. In addition to advances in the surgical procedure, there have been advances in post-operative rehabilitation that have seen a return to sports activity, in most cases, in less than six months.

Research in the area is ongoing and new techniques are constantly evolving, often an artificial graft (LARS) can now be used instead of taking grafts of the Patella tendon or Hamstring. Future research is even looking at sponge based grafts that are used to connect the two ends of torn tendon and then injected with the individuals own blood to promote regrowth.

ACL Knee Injury Prevention

Research by Dr Donald Shelbourne, the world expert on ACL injury, has shown that there is a relationship between the size of the ACL and injury. Specifically, if you have a small ACL then you are more likely to suffer an ACL injury. Obviously you can't do much about the size of your ACLs, we'd recommend proprioception training using a Wobble Board, as well as avoiding sport when you are in a fatigued state as this can increase the risk of injury.

In terms of long term success rate, a program of strengthening exercises is imperative either after surgery or for conservatively treated tendons. Restoring strength, flexibility and balance to the knee will dramatically improve function and increase confidence on the injured leg. Seek advice froma qualified physiotherapist on exercises to help improve Glute, Quadricep, Hamstring strength in particular as well as functional exercises for balance and coping with changes of direction, not just in sport but everyday life.







Row View Grid View

Donjoy TROM Advance Cool

£92.30 inc VAT

State-of-the-art hinged knee brace for rehab following knee surgery.
More Details

Donjoy TROM Advance Cool has a rating of 5.0 stars from 2 reviews (2 reviews)

Availability: Delivered in 2-3 days

Quantity

PhysioRoom Elite Hinged Knee Brace - Adjustable Ligament Support - ACL Knee Injury Rehab - Arthritis

£39.98 inc VAT

A high quality knee brace, designed for the treatment of knee ligament injuries and cartilage tears.
More Details

PhysioRoom Elite Hinged Knee Brace - Adjustable Ligament Support - ACL Knee Injury Rehab - Arthritis has a rating of 5.0 stars from 37 reviews (37 reviews)

Availability: In Stock

Quantity

PhysioRoom Hinged Knee Brace - Knee Ligament Support & ACL Rehab - Pain Relief for Arthritis

£21.99 inc VAT

The elite hinged knee brace has been designed for the rehabilitation of ACL and other severe knee ligament injuries. The hinged knee brace also helps to stabilise the patella and the collateral ligaments.
More Details

PhysioRoom Hinged Knee Brace - Knee Ligament Support & ACL Rehab - Pain Relief for Arthritis has a rating of 4.5 stars from 37 reviews (37 reviews)

Availability: In Stock

Quantity

Donjoy X-Act Orthopedic Hinged Knee Brace - Knee Surgery Ligament Support - Post-Surgery Rehab

£109.98 inc VAT

The X-Act ROM Knee is the lightest post-surgery brace currently manufactured by Donjoy and takes comfort, fit and functionality to the next level.
More Details

Availability: In Stock

Quantity

medi Collamed Wrap Around Knee Brace - Hinged & Padded Knee Support for Injury Recovery

£184.00 inc VAT


More Details

medi Collamed Wrap Around Knee Brace - Hinged & Padded Knee Support for Injury Recovery has a rating of 5.0 stars from 1 reviews (1 review)

Availability: Delivered in 3 days

Quantity

medi Hinged Fabric Knee Brace - Patella Tracking Knee Support - Injury Rehab & Protection

£183.40 inc VAT


More Details

medi Hinged Fabric Knee Brace - Patella Tracking Knee Support - Injury Rehab & Protection has a rating of 5.0 stars from 1 reviews (1 review)

Availability: Delivered in 3 days

Quantity

PhysioRoom Hinged Knee Brace - Knee Ligament Support - with Reusable Hot/Cold Pack

£39.99 inc VAT


More Details

PhysioRoom Hinged Knee Brace - Knee Ligament Support - with Reusable Hot/Cold Pack has a rating of 5.0 stars from 2 reviews (2 reviews)

Availability: In Stock

Elite Pro Mesh Hinged Knee Brace Quantity

PhysioRoom Elite Hinged Knee Brace - Adjustable Ligament Support & Gel Pack - Ligament Injuries - ACL

£44.99 inc VAT


More Details

PhysioRoom Elite Hinged Knee Brace - Adjustable Ligament Support & Gel Pack - Ligament Injuries - ACL has a rating of 5.0 stars from 11 reviews (11 reviews)

Availability: In Stock

Elite Hinged Knee Brace Quantity

medi Stabimed Hinged Knee Brace - Wrap Around Knee Ligament Support - Compression

£149.99 inc VAT


More Details

medi Stabimed Hinged Knee Brace - Wrap Around Knee Ligament Support - Compression has a rating of 5.0 stars from 3 reviews (3 reviews)

Availability: Delivered in 3 days

Quantity

medi Stabimed Pro Hinged Knee Brace - Wrap Around Knee Ligament Support - Compression

£110.00 inc VAT


More Details

medi Stabimed Pro Hinged Knee Brace - Wrap Around Knee Ligament Support - Compression has a rating of 4.0 stars from 6 reviews (6 reviews)

Availability: Delivered in 3 days

Quantity

Donjoy Playmaker II Spacer Knee Sleeve - Hinged Knee Ligament Support Brace - ACL

£124.99 inc VAT


More Details

Availability: Delivered in 2-3 days

Quantity

Donjoy Playmaker II Knee Sleeve - Hinged Knee Ligament Support Brace - ACL Rehab

£134.99 inc VAT


More Details

Availability: Delivered in 2-3 days

Quantity

Mueller Hg80 Premium Hinged Knee Brace - Patella & MCL Knee Support - Weak Knee Stabiliser

£94.98 inc VAT


More Details

Mueller Hg80 Premium Hinged Knee Brace - Patella & MCL Knee Support - Weak Knee Stabiliser has a rating of 5.0 stars from 3 reviews (3 reviews)

Availability: In Stock

Quantity

PhysioRoom Instant Ice Pack

From £0.75 inc VAT     1+ £1.99 each
    6+ £1.69 each (Save 15%)
  12+ £1.19 each (Save 40%)
  24+ £0.95 each (Save 52%)
  50+ £0.75 each (Save 62%)

A mouldable pack that becomes an instant, single use ice pack, without the need for refrigeration.
More Details

PhysioRoom Instant Ice Pack has a rating of 5.0 stars from 22 reviews (22 reviews)

Availability: In Stock

Quantity

Physicool Cooling Bandage (10cm x 2m) - Wrists, Ankles, Elbows

£10.00 inc VAT

Physicool is an innovative and uniquely designed reusable strapping that combines the healing characteristics of cold therapy with the support qualities of a compression bandage. Differing from the more traditional treatments currently available, Physicool works by drawing heat away from the body to provide an instant long-lasting cooling effect which can be utilised for extended periods.
More Details

Physicool Cooling Bandage (10cm x 2m) - Wrists, Ankles, Elbows has a rating of 5.0 stars from 7 reviews (7 reviews)

Availability: In Stock

Quantity

PhysioRoom Ankle and Wrist Weights x2 1 Pound

£6.48 inc VAT

The PhysioRoom.com Ankle and Wrist Weights each weigh one pound and feature a soft, terrycloth fabric on the inside to ensure a very comfortable fit.
More Details

PhysioRoom Ankle and Wrist Weights x2 1 Pound has a rating of 5.0 stars from 5 reviews (5 reviews)

Availability: In Stock

Quantity

Donjoy Drytex Playmaker Knee Brace - Adjustable ACL Knee Ligament Support - Sports Injury

£92.99 inc VAT

Superb sports and skiing hinged knee brace for ACL knee ligament injuries and cartilage tears. Has hi tech hinge system that can be locked at 9 different ranges of knee bend.
More Details

Donjoy Drytex Playmaker Knee Brace - Adjustable ACL Knee Ligament Support - Sports Injury has a rating of 5.0 stars from 5 reviews (5 reviews)

Availability: Selected options in stock

Quantity

Donjoy Armor Fourcepoint Hinged Knee Brace - ACL Ligament Knee Support - Post Surgery Rehab

£499.98 inc VAT

ULTIMATE ACL protection - ideal for ACL rehabilitation, sports use and skiing. Delivers an excellent fit with superb comfort.
More Details

Donjoy Armor Fourcepoint Hinged Knee Brace - ACL Ligament Knee Support - Post Surgery Rehab has a rating of 5.0 stars from 8 reviews (8 reviews)

Availability: Delivered in 2-3 days

Quantity

Aircast Knee Cryo/Cuff (Self Contained)

£63.48 inc VAT

Specialist knee ice therapy device. Fill it with ice and water to minimise swelling and pain following knee injury. One size fits all.
More Details

Aircast Knee Cryo/Cuff (Self Contained) has a rating of 4.5 stars from 8 reviews (8 reviews)

Availability: In Stock

Quantity

Aircast Knee Cryo/Cuff with Cooler

£91.99 inc VAT

Ultimate knee ice therapy. Provides 6 hours continuous cold and compression to minimise bleeding, swelling and pain.
More Details

Aircast Knee Cryo/Cuff with Cooler has a rating of 5.0 stars from 47 reviews (47 reviews)

Availability: In Stock

Knee Cryo/Cuff Quantity

Row View Grid View





Knee Injuries