Dr Sumit Mahajan
Sports persons are prone to injuries and effect deleteriously there professional life. Knee is most commonly affected. Knee is stabilized by various ligaments like anterior and posterior cruciate ligaments, medial and lateral meniscus and collateral ligaments. These ligaments are like strong ropes, keeping the knee stable. One of the most common knee injuries is a tear of the anterior cruciate ligament, or ACL. The incidence of injuries to the anterior cruciate ligament is estimated at 200,000 injuries per year. The most common reasons the ACL tears include sudden change in direction, hyperextension of the knee, stopping suddenly, deceleration while running, landing awkwardly from a jump and direct collisions
ACL injuries occur when bones of the leg twist in opposite direction under full body weight
As people experience these “giving way” events, they lose trust in their knee, making it very difficult to participate in sports that involve cutting, pivoting and twisting or sudden change in speed and direction. Some people even have “giving way” events with usual, daily activities. ACL tears that are left untreated often lead to injury to the cartilage of the knee. With a torn ACL, the knee is at risk for “giving way” episodes. During one of these episodes, the knee pivots and the smooth cartilage surfaces sheer against one another, which can cause damage to the cartilage or cause the meniscus to tear. Damage to the meniscus and smooth cartilage predisposes the knee to developing arthritis. Each “giving way” event puts the knee at further risk for damage.
The treatment of ACL tears is only surgical to restore stability and function of the knee and return to normal sporting activites. In an ACL reconstruction, a “graft” is used to rebuild the torn ligament. The graft used to reconstruct the ACL is one’s own tissue (autograft). The most commonly used autograft tissues are taken from either the patellar tendon or the hamstring tendons. The procedure is done with an arthroscope through 2-3 small incisions. This “scope” contains optic fibers that transmit an image of your knee through a small camera to a television monitor. At this time, other possible problems, such as meniscal tears or cartilage damage, can be addressed. During the procedure, surgeon will drill a small tunnel through the femur and the tibia. The graft is fed into bone tunnels and held in place with a fixation device. Tunnels are drilled to secure graft.
(The author is consultant Max Superspeciality Hospital, Mohali)
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