ACL Rupture in Sports
Jacquelyn Holguin, Roy Ramirez, Audrey Beltran
Seen more commonly in athletes, an injury to the anterior cruciate ligament can be a debilitating musculoskeletal injury to the knee. The most common cause of ACL injuries are Non-contact tears and ruptures. The anterior cruciate ligament (ACL) is a significant ligament for proper movement. An ACL injury causes knee instability that causes injury to other knee ligaments. Injuries of the ACL range from mild, such as small tears, to severe when the ligament is completely torn.
There are several ways the ACL can be torn; the ligament tears due to it being overstretched. The movements of the knee that can result ...view middle of the document...
Pain is also a major symptom in an ACL injury and can range from moderate to severe. Continued athletic activity on a knee with an ACL injury can have upsetting consequences. This can result in huge cartilage damage, leading to risk of developing osteoarthritis later on in life. Other problems include anterior knee instability. Such injury is also a common cause of non-contact knee injury in football, falls occur when the knee gives way sometimes without warning.
ACL injuries occur when an individual stops suddenly or plants their foot hard into the ground (cutting). ACL failure has been linked to heavy or stiff-legged landing; the knee rotating while landing, especially when the knee is in an unnatural position. Women in sports such as basketball, tennis and volleyball are more likely to get ACL injuries than men. The difference has been attributed to the sexes in anatomy, general muscular strength, reaction time of muscle contraction and coordination, as well as training techniques. A recent study suggests hormone-induced changes in muscle tension associated with menstrual cycles may also be an important factor.
The majority result of flat footed athletes is ACL injuries. The second result directs the forces directly up the tibia into the knee, while the straight-knee position places the anterior femoral condyle on the back-slanted portion of the tibia. The resulting forward slide of the tibia relative to the femur is restrained mainly by the now-vulnerable ACL.
ACL tears occur for two reasons: failure load of the ligament and the mechanical load applied to it. Female ACLs will fail at rather lower loads than males, and female pelvic anatomy also influences women to higher mechanical loads on the knee. The combination of these factors leads to an increased likelihood for females to tear their ACLs.
When an ACL injury is suspected the pivot-shift test, anterior drawer test and the Lachman test are done during the clinical examination. The ACL can also be visualized using a magnetic resonance imaging scan (MRI scan). Though clinical examination in expert hands is highly accurate, the diagnosis is usually confirmed by MRI. MRI has a higher accuracy than clinical examination in detecting ACL tears when multiple ligaments are torn. This is of particular benefit if there is a coexisting posterolateral corner injury.
One of many medical tests used to determine the integrity of the anterior cruciate ligament is the anterior drawer test. It can be used to help diagnose sprains and tears. The test is done as followed:
The patient is placed lying supine with the hip flexed to 45° and knee to 90°. The examiner sits on the examination table in front of the involved knee and holding the tibia just below the joint of the knee. The examiner’s thumbs go along the joint line on either side of the patellar tendon. The index fingers then palpate the hamstring tendons to make sure they are calm; the hamstring muscle group must be relaxed for a proper...