Laura Zwald
ACL Research
Interview
1. What is the function of the ACL?
Answer: The major function of the ACL is to
prevent over use of certain parts of the knee, mainly anterior, in an
assortment of degrees in flexion. In flexion of the knee, the anteromedial band
of the ligament prevents anterior repositioning, and the posterolateral band
maintains stability in the knee. So basically, it keeps the knee from
hyperextending, limits excessive rotation, and helps restrain stresses on the
knee; it connects the femur to the tibia.
My reflection: This answer was very helpful
in my overall research, as this is one of the main bases of my question. The knee has many different ligaments,
joints, etc. but the ACL has a lot to do with balance and positioning of the
knee. With the knee being a big part of movement and function overall, the ACL
is vital in keeping the body in good condition.
2.
For athletes specifically, what is the surgical
process for ACL tears?
Answer: In order to reconstruct the ACL,
the torn ACL is replaced with either small segments of the hamstring or
patellar tendon to create a new ACL. Two incisions around your knee are made in
order to put an arthroscope to see inside the joint followed by a sterile
solution to enable a clear path. Of
course, the procedure is under general anesthesia. Typically for athletes, we use the patellar
tendon, in which we use the middle third of the tendon and take out the torn,
existing ACL. Small incisions are then drilled into the upper and lower leg
bones around the knee joint. This allows
the new ligament to screw into place, so to say. Then everything is closed and
cleaned up sutures.
My reflection: Striving to be an orthopedic
surgeon, this insight is exactly what I need.
I hear small segments of this procedure in appointments, but getting to
hear the full story is very interesting.
This lets me know how the bones, joints, ligaments perform and react to
one another more clearly.
3.
What type of rehabilitation is required after
surgery?
Answer: Patients are given a set of daily
exercises to start immediately after surgery in order to fully recover. Braces are given and checkups to ensure
stability. Physical Therapy is very important!
My Reflection: Throughout my duration at
Longstreet Clinic with Dr. Borrow, I have learned that physical therapy is a
must. Some patients decide to perform
the exercises on their own but it is crucial for them to follow through. In order to repair any injury, even if it
hurts, the blood has to keep flowing and stiffness is not allowed!
4.
How long is an athlete unable to exercise after
tearing an ACL?
Answer: Four to six months is the typical
full recovery rate. However throughout
those months, physical therapists and trainers are slowing increasing the
motion, stability and strength in the knee and related muscles. More confidence in the knee must be gained
as well in order for the athlete to be able to perform with excellence. The process is lengthy and tedious but
required to prevent another tear.
My reflection: Through sports, I have had an indication of
the length of time it takes athletes to obtain an ACL tear, but hearing the
other information gives a more exact answer and reasoning. Having a ligament, such as the ACL, torn is a
huge deal and must be treated extra careful to return with a full recovery.
5.
What are possible complications of an ACL
surgery?
Answer: Every surgical procedure has a risk
of infection or bleeding but for ACL surgeries, the rate of infection is 0.2
percent and bleeding is less than one as well.
The most common complication would be loss of motion following the
surgery. Some loss of motion is very
minor while others can be much more dramatic.
This is why rehabilitation so vital to the ACL and started so soon. Some
patients also experience anterior knee pain after surgery, but this is mostly
related to loss of motion as well.
My reflection: Often people stress over surgeries and worry
something will go wrong either in the operating room or within their body
post-operatively; however this nearly ensures that if the correct produces are
followed by the patient, nothing is to worry about. This also demonstrates the
importance of physical therapy.
6.
What is the most common way to tear the ACL?
Answer:
Typically, quickly changing direction, sudden stopping, landing from a
jump wrong, direct contact and collisions, and sometimes slowing down while
running are the ways people and athletes tear his or her ACL.
My reflection: This explains how many of my soccer teammates
have torn their ACL and why it is a common injury in athletes. Each of these scenarios are common in any
sport and often inevitable. This furthers my knowledge on how and why ACL tears
occur.
7
.
Some say ACL tears are more common in females,
is this true?
Answer: It has been shown that females do
have a higher rate of injury with the ACL than males. This also depends on sport, however. Differences in physical fitness, strength in
muscles and muscular nerve control.
Increased looseness and estrogen in ligaments also play a small role.
My reflection: I always wondered the answer
to this question, and it does make sense.
Females naturally have less muscle mass and obviously a higher level of
estrogen that plays a huge role in the body.
8
.
What is the probability of athletes re-tearing
the ACL?
Answer: There is no set probability;
however, in the first two years after reconstruction the rate is much
higher. It is very important that
athletes take the time and effort to attend physical therapy and hereby to the
rules of recovery. The ACL is much more
vulnerable directly after tear that before or long periods of time after, so
the two years of rehab are crucial.
My Reflection: through many of the answers
to these questions, it has become more obvious that physical therapy and rehabilitation
are crucial in order to fully recover and avoid repeated injury. Athletes often think they are invisible (me
being one) but just like any other human, it is highly important to take on the
right precautions.
9
.
Some people decide to take non-surgical
treatment for ACL injuries, what does this involve?
Answer: The basic steps are simply rest,
ice, and compress and elevate, as is for many injuries. The goal is to regain extension and walking
with full weight; however, this is a must within seven to ten days. If tear isn’t bad enough and treated fast
enough, the knee should be back to normal within around three weeks. Even after this though, the patient needs to
attend physical therapy with more intense exercises to ensure recovery.
My Reflection: typically, for such intense
injuries, non-surgical treatment is foolish.
However it was interesting to see that in certain cases, it can be very productive!
I’m sure though that this type of rehabilitation should not be used on athletes
unless the tear is extremely minor.
1
How common are ACL injuries?
Answer: ACL injuries are actually the most
common knee injuries for athletes and have been said to have more than 100,000
tears in the United States per year. Not
to forget they bring in a lot of money for health care.(:
My Reflection: Being an athlete, it is not a
secret that ACL injuries are very common, and scary. But I had no idea just how common they
were. This injury is a nightmare and
musts players out of an entire season and to affect that many people a year is
astronomical. Hopefully, I don’t have to
experience this.
