Anterior Cruciate ligament (ACL)


Anterior Cruciate Ligament

The anterior cruciate ligament (ACL) is a cruciate ligament which is one of the four major ligaments of the human knee. The ACL originates from deep within the notch of the distal femur. Its proximal fibers fan out along the medial wall of the lateral femoral condyle. There are two bundles of the ACL—the anteromedial and the posterolateral, named according to where the bundles insert into the tibial plateau. The ACL attaches in front of the intercondyloid eminence of the tibia, being blended with the anterior horn of the medial meniscus.

An injury to the ACL can be a debilitating musculoskeletal injury to the knee, seen most often in athletes. Non-contact tears and ruptures are the most common causes of ACL injury. The ACL is an important ligament for proper movement. ACL injury more commonly causes knee instability than does injury to other knee ligaments. The movements of the knee that can result in a tear is when the knee is straightened more than 10 degrees beyond its normal maximal position (hyperextension) - the lower leg is forced forward in relation to the upper leg. Tears in the anterior cruciate ligament often take place when the knee receives a direct impact from the front of the thigh while the leg is in a stable position. Research has shown that women involved in sports are more likely to have ACL injuries than men. ACL tears can also happen in older individuals through slips and falls and are seen mostly in people over 40 due to wear and tear of the ligaments. An ACL tear can be diagnosed by a popping sound heard after impact, swelling after a couple of hours, severe pain when bending the knee, and when the knee buckles or locks during movement or gives way while standing still with weight on the affected knee.

A torn ACL can't be successfully sewn back together, so the ligament is replaced with a piece of tendon from another part of your leg or from a deceased donor. ACL reconstruction is carried out to try to make your knee stable. This means that you may be able to return to playing sport, but that will depend on whether there are other problems with your knee such as torn cartilages, other ligament injuries or arthritis.


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