Anterior cruciate ligament (ACL)

Anterior cruciate ligament

The anterior cruciate ligament (ACL) is one of the most studied and discussed topics in the Sports Medicine community, likely due to its high injury rate and burden. The ACL, together with the other ligaments of the knee joint, have the paramount function of providing stability to the knee simultaneously supporting the optimal alignment and reciprocal movement of femur and tibia, controlling their translations and rotations. The increased strain on the ligament and its subsequent rupture is dictated by a number of different factors that make these types of injuries multifactorial. Currently, the most relevant evidence on injury epidemiology suggests that these injuries mainly occur during sports activities (such as soccer, basketball, skiing, etc.) and that their injury mechanisms are sport-specific and unique to each sport. Our Medical Group has invested significant resources in identifying these patterns through research with the goal of optimising the recovery of our patients by including sport- and injury-specific retraining programmes based on the patient’s needs throughout the rehabilitation.

Management

Commonly, ACL injuries result in severe pain, swelling, instability and limited movement of the knee. Surgical and non-surgical approaches are both available options after these injuries, however, the specifics of each path must be thoroughly discussed between the medical team and the patient, to tailor the recovery process to the person’s conditions, needs and circumstances. Isokinetic Medical Group can support your recovery and return to activity from the beginning, by guiding you in identifying the best recovery route for your condition. In cases where rehabilitation alone is considered insufficient and knee surgery is required, our excellent relationships with Orthopaedic Surgeons will allow us to promptly refer you to them for a surgical opinion.

Anterior Cruciate Ligament surgery

The final aim of any surgical procedure in the context of ACL is to restore and support the stability of the knee joint to allow its optimal functioning. Different types of surgeries have been suggested over the years, however, Anterior Cruciate Ligament Reconstruction (ACLR) is currently the most implemented and successful procedure. Different grafts can be implemented to reconstruct the ruptured ligament, and their selection is usually a delicate process that is addressed together with the surgical team based on the patient’s needs. Most importantly, every surgery presents specific characteristics that the rehabilitation team must consider throughout the rehabilitation process to be successful, and our expertise as Isokinetic Medical Group matured in over 30 years of ACLR rehabilitation includes attention to the smallest details. After surgery, patients are typically ambulating with the use of crutches and the use of a brace is at the discretion of the surgeon team, often depending on the performed concomitant procedures (e.g.: meniscal repair, collateral ligament surgery, etc.).

Rehabilitation

Regardless of the implemented recovery pathway (surgical vs non-surgical), rehabilitation should be started as soon as possible as delays or malpractices in the early stage of the recovery can lead to important consequences and negative outcomes. Especially with these injuries, patients are strongly recommended to be guided and assisted by a specialised Medical Team that can take care of the whole recovery process, from the beginning to the end. In Isokinetic, our ideal rehabilitation pathway is structured in different stages of rehabilitation, and it is carried out in several environments that best suit the specific stage rehabilitation goal, such as hydrotherapy, rehabilitation gym, movement analysis retraining room and on field-rehabilitation. In our Method, the patient’s progression is guided by specific tests that support a safe and effective advancement in the rehabilitation process, including the isokinetic test (strength and endurance), the threshold test (fitness and conditioning), the movement analysis test (movement quality assessment) and the implementation of high-level technology such as GPS data during the on-field rehabilitation. At the end of our rehabilitation pathway, our patients are always reviewed by a doctor for a final assessment and clearing to return to their activity in order to prevent re-injuries and optimise their return to sport success.