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Anterior Cruciate Ligament (ACL) Injuries
Anterior cruciate ligament (ACL) injuries are one of the most common knee injuries, particularly among athletes who participate in high-demand sports such as soccer, football, and basketball. Understanding the anatomy, causes, symptoms, diagnosis, and treatment options for ACL injuries is crucial for effective management and recovery.
Overview
Anatomy
Three bones meet to form the knee joint: the femur (thighbone), tibia (shinbone), and patella (kneecap). The patella sits in front of the joint to provide some protection. Ligaments connect bones to other bones, and there are four primary ligaments in the knee:
- Collateral Ligaments: Located on the sides of the knee. The medial collateral ligament (MCL) is on the inside, and the lateral collateral ligament (LCL) is on the outside. They control the side-to-side motion of the knee.
- Cruciate Ligaments: Located inside the knee joint. They cross each other to form an X, with the anterior cruciate ligament (ACL) in front and the posterior cruciate ligament (PCL) in back. The ACL prevents the tibia from sliding out in front of the femur and provides rotational stability to the knee.
Description ACL Injuries
About half of all ACL injuries occur along with damage to other structures in the knee, such as articular cartilage, meniscus, or other ligaments. Injured ligaments are considered sprains and are graded on a severity scale:
- Grade 1 Sprains: Mildly damaged ligament, slightly stretched but still stable.
- Grade 2 Sprains: The ligament is stretched to the point of becoming loose; often referred to as a partial tear.
- Grade 3 Sprains: A complete tear of the ligament, causing the knee joint to be unstable.
Cause
ACL injuries can occur from:
- Rapid changes in direction
- Stopping suddenly
- Slowing down while running
- Incorrectly landing from a jump
- Direct contact or collision, such as a football tackle
Female athletes have a higher incidence of ACL injuries, potentially due to differences in physical conditioning, muscular strength, neuromuscular control, pelvis and lower extremity alignment, ligament looseness, and the effects of estrogen on ligament properties.
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