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Cruciate
Ligaments of the Knee
Anterior Cruciate Ligament
The anterior cruciate ligament (ACL) in the knee prevents
the tibia from sliding upon the femur by acting like a tether
or rein. Injury to the ACL usually results from a twisting
injury. Swelling, pain and instability in the knee generally
point to an ACL tear. A physician will assess the knee for
the severity of the sprain. X-rays are taken to rule out
small associated fractures, and sometimes an MRI (magnetic
resonance imaging) is necessary to confirm ligamentous tears
and evaluate possible meniscal injury as well.
Treatment of partial ligament tears include a brief period
of rest (24-72 hours), the use of anti-inflammatory medication,
compression bandages, elevation and ice in an effort to
reduce swelling. A gradual program of quadriceps and hamstring
strengthening is emphasized as well. A dedicated physical
rehabilitation program can be helpful for a return to full
activity. Patients with complete tears are evaluated for
potential recovery after nonsurgical treatment. Consideration
is given to age, weight, activity level and severity of
the injury.
If surgery is selected by both the physician and the patient,
a ligament is reconstructed usually from the patient's own
bone and tendon. Surgical intervention is generally quite
successful if undertaken in conjunction with a dedicated
physical therapy program. The reconstructed ligament itself
takes up to a year to fully heal, but a patient can gradually
return to weight bearing and athletic activity as he or
she progresses through the rehabilitation program.
Posterior Cruciate Ligament
The posterior cruciate ligament also extends from the tibia
to the femur, but in the back of the leg. It prevents the
tibia from sliding backwards. Sprains of this area tend
to occur in tandem with other major injuries to the knee.
Posterior cruciate ligament (PCL) tears can be managed conservatively
with a program of physical therapy emphasizing the hamstring
and quadriceps muscle groups. With this injury, patients
report a vague feeling of instability and this injury is
generally confirmed with an MRI (magnetic resonance image).
If surgical management of this injury becomes an option,
a lengthy and dedicated period of physical rehabilitation
ensues, especially when other knee injuries are involved.
Most patients respond well to treatment, however, and can
return to an active life.
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