Anterior Cruciate Knee Pain

A torn ACL is sadly common among those who play sports. The anterior cruciate ligament is responsible for a large part of the stability of the knee, and when it is damaged, you know it. Not only is there pain in the knee, which can range from moderate to excruciating, but there is definite instability---the feeling that the knee is about to "buckle." In most cases, an ACL injury is something that cannot be ignored, and will have to be addressed by a medical professional. This article will give you some information on the anterior cruciate ligament and pain in that specific area of the knee.

Significance

• The significance of the anterior cruciate ligament is that it prevents forward motion of the lower leg bone (tibia) from under the upper leg bone (femur). The anterior cruciate ligament runs in a cross pattern with the PCL (posterior cruciate ligament) right in the middle of the knee joint. These two ligaments, working together, keep the knee joint stable by providing a stopping place for the leg bones as they work with the patella during movement. When this ligament is injured, which happens most often when the foot is soundly planted and knee is twisted or sustains a severe blow causing the joint to twist, the knee buckles and without the stability provided by a sound ACL, the knee is not safe to rely on.

Symptoms

• The most obvious symptom will occur at the time of injury. There is often a loud pop or snapping sensation in the knee joint when the ACL tears or is ruptured. The knee buckles and the patient is unable to walk on the joint with any stability. The pain will be severe at the time of injury, and even though it may wane with the passing hours, the swelling will worsen and the instability of the joint will continue. If the person tries to walk or bear weight, the knee will give and there will be tremendous pain. Swelling can be moderate at first, and then will rapidly worsen until it becomes obvious there is a need for medical help. If you experience these symptoms, you need to get to an orthopedic doctor as soon as possible.

Treatment

• While there are some very rare cases in which rest and bracing may allow a very minor ACL tear to heal over an extended period of time, most ACL tears will need surgical treatment. In the case of an ACL rupture, there is no other alternative. If the patient ever wants to have a stable knee to walk on, they will need to have surgery to fix the ligament. Most ACL tears can be repaired arthroscopically. Two to three small incisions are made, instruments are inserted through these incisions, and the damaged ligament is either repaired or removed. In the case of removal, a graft is taken either from the patient or from a deceased donor and applied through holes that are drilled through the joint, and secured with pins, staples, or sutures. Most of the time this surgery can be performed on an outpatient basis, but rehabilitation is long, arduous, and must be followed to the letter.

Physical Therapy

• One of the most critical treatments for anterior cruciate pain is physical therapy. Even in the rare cases where surgery is not performed, physical therapy is a must. The injury will be extensively rehabbed for up to six months after the initial treatment. In the case of surgery, physical therapy will begin within hours of recovery. Quad sets will be the first exercise, and it is usually done on the same day as the surgery. Therapy will move onto leg lifts, and a host of other leg strengthening exercises that will slowly and carefully re-engage the quadricep muscles and strengthen the muscles surrounding the knee. Physical therapy for the ACL is arduous, painful, and requires determination and stamina. But, in order to have a successful outcome, it is necessary.

Pain Control

• Immediately after the injury, the best treatment is the I.C.E. method. This stands for (I)cing the joint. Using a (C)ompression bandage, like an Ace bandage on the knee to help support it, and (E)levating it to help reduce swelling. You can also take NSAIDs---Non-Steroidal Anti-Inflammatory Drugs---like Ibuprofen, aspirin, and Tylenol. Once you have seen a heath care professional, they are likely to prescribe some prescription pain medication, such as Vicodin or Darvocet, to help you with the pain until you receive the necessary treatment to help with the injury. In the case of surgery, additional prescription pain medications will be given to help with post-surgical pain control. Your doctor will help you with these medications---their dosage and instructions on their use.