Plans for a blog series addressing one of our most common patient complaint has been on our topic list for some time. We recently visited the new Hard Rock Stadium for a University of Miami Hurricane game and here, in this brand new setting being in the midst of football season, seemed like the perfect time to launch our new series on knee pain.
Dr. Bruce Fletcher and Dr. Elliott Hinkes both are graduates from the prestigious University of Miami School of Medicine and have been Cane supporters and fans for over 20 years. During that time they have witnessed football field collisions and maneuvers resulting in the first knee condition we will address in our series; the ACL tear.
If you are a sports fan, most certainly you can recall one of your favorite athletes being out of commission due to ligament tear. For example, before the 2016 season even started, Hurricanes’ running back Trayone Gray and wide receiver Lawrence Cager both sustained ACL injuries during practice.
Back in 2008, New England Patriots’ quarterback, Tom Brady, suffered an ACL tear during a game against the Kansas City Chiefs. While this type of injury may put a player out for a season, it is not the career-ending injury it used to be in the past due to advancements in arthroscopic surgery. As a matter of fact, most players go on to perform on par to their pre-injury abilities and are pain free.
Pain is classified in two categories: acute and chronic. Acute pain occurs suddenly, usually as the result of a traumatic injury. Chronic pain is longstanding and may become progressively worse over time. Sustaining an ACL injury can be extremely painful, but what exactly is an ACL?
When looking at the anatomy of the knee, there are four major ligaments which keep the knee functioning and the components in place. On the inside portion of the knee you have the medial collateral ligament. Directly across, on the outer aspect, is the lateral collateral ligament. The medial and lateral ligaments control the sideways motion of the knee. The cruciate ligaments actually reside inside the knee itself. Their formation is similar to an X with the posterior cruciate ligament being in the posterior (back) portion of the knee and the anterior cruciate ligament residing in the front of the knee. Combined these ligaments control the knee’s back and forth motion. The ACL (anterior cruciate ligament) keeps the tibia in place and stabilizes the knee.
A tear to the ACL is usually the result of an impact to the side of the knee; such as from a blow during football. A tear can also be caused by an overextension of the knee from a fall, a rapid change in direction, or quick stop. Tears can either be partial or complete with treatment options being dependent upon the severity of the injury. Common symptoms of a tear include pain, swelling, and knee instability. There may be an initial sensation of a snap or pop and the knee may even buckle. In order to treat the symptoms, a proper diagnosis is imperative. Without treatment the ACL is unable to provide stability to the knee and can result in the bones colliding and rubbing together. With over 200,000 cases of ACL injuries reported yearly, diagnosing is a simple process that can be performed with an MRI ordered by your orthopedic physician. Treatment options depend on the severity of the tear.
An anterior cruciate ligament reconstruction is performed in an outpatient setting and does not require hospitalization. Total time at the surgery center normally ranges from 4 to 5 hours. ACL reconstruction is a minimally invasive arthroscopic procedure. During the post-surgery phase a course of physical therapy is required to regain mobility and strength to the ligament. The combined modalities of treatment usually result in a highly successful recovery for the patient allowing them to return to their normal activities of daily living.