Anterior cruciate ligament (ACL)

Anterior cruciate ligament

The anterior cruciate ligament (ACL) is one of the most studied and discussed topics in the medical and sports community because of its high injury rate and consequences. The ACL, along with the other ligaments of the knee joint, has the fundamental function of providing stability to the knee by simultaneously supporting the optimal alignment and reciprocal motion of the femur and tibia, controlling their translations and rotations. Increased strain on the ligament and its subsequent rupture are dictated by multiple factors that make these types of injuries multifactorial. Currently, the most relevant studies on injury epidemiology suggest that these injuries occur mainly during sports activities (such as soccer, basketball, skiing, etc.) and that their mechanisms of injury are specific and unique to each sport. Our Medical Group specializing in cruciate ligament has invested significant resources in identifying these patterns through research, with the goal of optimizing the rehabilitation of our patients by including specific programs for recovery from ACL injury and prevention of future injuries based on the needs of the patient and the sport played

Management

Typically, ACL injuries cause intense pain, swelling, instability and limitation of knee motion.The recovery program after cruciate ligament rupture, involves two potential approaches, surgical and non-surgical, however, the specifics of each pathway must be discussed thoroughly between the medical team and the patient himself, to create the optimal recovery process based on the person’s condition, needs and circumstances. Isokinetic Medical Group can support your recovery and return to activity from the very beginning, guiding you in identifying the best recovery pathway for your condition. In cases where ACL rehabilitation alone is considered insufficient and knee surgery is required, our excellent relationships with orthopedic surgeons will enable us to promptly refer you to them for surgical advice.

Anterior Cruciate Ligament surgery

The ultimate goal of any surgical procedure in the context of the ACL is to restore and support the stability of the knee joint to allow it to function optimally. Several types of surgical procedures have been suggested over the years, however, ACL reconstruction is currently the most implemented and successful procedure. Several grafts can be used 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. More importantly, each surgery has specific characteristics that the rehabilitation team, experienced in cruciate ligament rupture, must consider throughout the postoperative ACL rehabilitation process to be successful, and our expertise as Isokinetic Medical Group gained from more than 30 years of ACL rehabilitation brings attention to the smallest details. After surgery, patients typically ambulate with the use of crutches, and brace use is at the discretion of the orthopedic team, often depending on the concomitant procedures performed (e.g., meniscus repair, collateral ligament surgery, etc.).

Rehabilitation

Regardless of the recovery path chosen (surgical vs non-surgical), rehabilitation should be started as soon as possible as delays or negligence in the early stage of recovery can lead to major consequences and negative outcomes. Especially with these injuries, it is strongly recommended that patients be guided and assisted by a team, cruciate ligament specialist who can take care of the entire recovery process from cruciate ligament injury from start to finish. At Isokinetic, our ideal ACL rupture rehabilitation pathway is structured into different phases of rehabilitation and is carried out in different settings that best suit the rehabilitation goal of the specific phase, such as hydrotherapy, rehabilitation gym, movement analysis and recovery room, and field rehabilitation. In our Method, patient progression is guided by specific tests that support safe and effective advancement in the rehabilitation process, including isokinetic testing (strength and endurance), threshold testing (fitness and conditioning), movement analysis testing (assessment of movement quality), and implementation of high-level technologies such as GPS data during field rehabilitation. At the end of our rehabilitation and physical therapy for ruptured anterior cruciate ligament, our patients are always seen by a physician for a final evaluation and clearance to resume physical activity in order to prevent new injuries and optimize return to sports.