Journal

Getting to know you series – ACL

Arthro Health

Many of our younger, active patients with ACL injuries require surgical treatment, for those that don't Andrew works closely with the patients allied health team to restore their mobility and return them to a more pain free and active life.

Melbournes best ACL surgeon Mr Andrew Chia

The anterior cruciate ligament, or ACL, is one of the major ligaments of the knee that is located in the middle of the knee and runs from the femur (thighbone) to the tibia (shinbone). It prevents the tibia from sliding out in front of the femur. Together with the posterior cruciate ligament (PCL), it provides rotational stability to the knee.

An ACL injury is a sports-related injury that occurs when the knee is forcefully twisted or hyperextended. An ACL tear usually occurs with an abrupt directional change with the foot fixed on the ground or when the deceleration force crosses the knee. Changing direction rapidly, stopping suddenly, slowing down while running, landing from a jump incorrectly, and direct contact or collision, such as a football tackle can all cause injury to the ACL. ACL injuries are the second most prevalent injury in the AFL (after hamstring injuries). In the AFLW ACL injuries were the most frequent injury to occur per 1000 player hours. ACL injuries also occurred at a highly concerning six (6) times higher rate in the women’s compared to men’s competitions.

Comparison with other sports that have reported sex discrepancies in ACL injury incidence further highlights the high incidence rate of ACL injuries in the AFLW. For example, in elite women’s soccer the mean incidence of ACL injury during match play is reported at approximately 0.72 injuries per 1000 player hours and twice that of the men’s competition. Read more about ACL in AFL and AFLW in this study published in 2021. We also featured this article in our “What Andrew is reading” series.

When you injure your ACL, you might hear a ‘popping’ sound and you may feel as though the knee has given out. Within the first two hours after injury, your knee will swell and you may have a buckling sensation in the knee during twisting movements.

Diagnosis of an ACL tear is made by knowing your symptoms, medical history, performing a physical examination of the knee, and performing other diagnostic tests such as X-rays, MRI scans, stress tests of the ligament and arthroscopy.

Treatment options include both non-surgical and surgical methods. If the overall stability of the knee is intact, your doctor may recommend nonsurgical methods. Nonsurgical treatment consists of rest, ice, compression and elevation (RICE protocol); all assist in controlling pain and swelling. Physical therapy may be recommended to improve knee motion and strength. A knee brace may be needed to help immobilise your knee.

ACL injuries and treatment by Mr Andrew Chia orthopaedic surgeon

Young athletes involved in pivoting sports will most likely require surgery to safely return to sports. The usual surgery for an ACL tear is an ACL reconstruction, which tightens your knee and restores its stability. Surgery to reconstruct an ACL is done with an arthroscope, using small incisions. Mr Andrew Chia specialises in this type of surgery and will replace the torn ligament with a tissue graft that can be obtained from your knee (patellar tendon) or hamstring muscle. Following ACL reconstruction, a rehabilitation program is started to help you to resume a wider range of activities. At ARTHRO Health we work closely with your allied health team to ensure the best outcome for our patients.

As always, should you wish to find out more, discuss ACL injuries or have any orthopaedic concerns, please contact our rooms, we are here to help.