It seems unjust that those of us who dedicate regular time to being active and physically fit, whether on the football pitch, netball court or pounding the pavements, are the ones most likely to be taken out by the dreaded knee injury.
The strain the knee joint is put under, and the rapid twisting movements some sports demand, unfortunately mean that sports injuries to the knee are extremely common. We asked Mr Raj Thakrar, Consultant Knee and Trauma & Orthopaedic Surgeon at One Hatfield Hospital, to tell us more.
What are the most common sports injuries to the knee?
In my clinic I regularly see simple sprains, cartilage tears and ligament injuries. One of the most common ligament injuries is to the Anterior Cruciate Ligament (ACL). ACL injuries account for almost half of sports related injuries and can range from a small tear to quite a complex injury where the ligament tears and completely separates from the bone.
What is the Anterior Cruciate Ligament?
The ACL is a strong internal band of tissue that crosses your knee to join the thigh bone to the shin bone. It runs diagonally through the inside of the knee to give the knee joint stability and helps control the back-and-forth movement of the lower leg.
How is the ACL injured?
The most common mechanism of injury is a twisting motion of the knee joint. Common causes include landing badly from a jump, stopping or changing direction suddenly, or having a collision such as during a football tackle. You may experience a loud popping sound or sensation, although this does not happen to everyone. The most common symptoms include pain and swelling of the knee joint. It is likely to you will be unable to fully bend and straighten your knee and you may feel as though the knee is unstable and wants to buckle.
Will an injured ACL heal overtime?
A mild injury may stretch the ligament but leave it intact. Rest, ice pack and anti-inflammatory pain medication may be enough and a course of physiotherapy will definitely be of benefit to strengthen the muscles around the knee and get you back physical activity.
When would surgery be recommended?
It will depend on the extent of the damage and if your quality of life is affected. If your knee feels stable and you do not have an active lifestyle, you may decide not to have surgery. I would recommend ACL reconstruction surgery if the knee is buckling during everyday activities, or when performing sports, particularly if the sport involves jumping or pivoting.
How is ACL reconstruction surgery performed?
We do this arthroscopically through small incisions around the knee joint, one to hold a thin, tube-like video camera (arthroscope) and others to allow surgical instruments access to the joint. The torn ligament is removed and replaced with a piece of tendon from another part of your knee. The new tendon will be attached to your thighbone and shinbone and serve as your new ACL.
How long will it take to recover?
For the first 2 weeks you will need to rest, elevate and ice the knee often. Physiotherapy will be crucial to strengthen your muscles and regain full range of movement. You may need to use crutches for up to 2 weeks and should expect to have up to 6 weeks off work and driving. A full recovery and return to sport is expected after 9 months.