Due to the rapid increase in the number of people of all ages doing sports, the frequency of knee ligament injuries is also increasing. There are 4 important ligaments (anterior cruciate, posterior cruciate, inner lateral and outer lateral ligaments) that ensure the stability of the knee joint.
These ligaments connect the thigh bone (femur) and the leg bone (tibia) and provide the anteroposterior and lateral stability of the knee.
The anterior cruciate ligament is often torn as a result of a sports activity. The most common form of injury occurs in high-tempo sports such as football and basketball, usually during the sudden rotation of the body on a fixed foot, and there may usually be no impact or contact.
A tear may occur when the body is forced to turn on the knee while the foot is stationary, especially if a sudden turning movement is made after the spiked football shoes are stuck in the ground. During an anterior cruciate ligament injury, the knee swells within a few hours with a sudden feeling of tearing in the knee. The cause of this swelling is bleeding into the knee from the torn ligament. Meanwhile, a sound may be heard from the knee.
Approximately 2 out of 3 athletes whose knee swells after injury should be considered to have a ruptured ACL. An important clue is that the patient says that his knee "turned" and "he heard a sound coming from his knee" at the time of trauma. An athlete whose ACL is torn cannot continue playing despite all his/her wishes.
Swelling and pain in the knee joint will decrease within a few days - weeks. Knee movements are gained and limping disappears. After this acute period has passed (after 3 weeks), the main complaints begin. The most common complaints we encounter with patients are the feeling of insecurity and discharge in the knee. They come to the doctor because of not being able to run, not doing sports, feeling of insecurity in sudden jumping, stopping and turning movements, and ejaculation. They complain that they cannot control their knees, especially when descending stairs, and that there is insecurity in their knees.
In acute tears, the patient presents with swelling in the knee, the knee is extremely painful and tense, sometimes it may not be possible to perform specific examination tests due to the pain. In all patients with serious knee injuries, X-rays should be obtained and the bones should be investigated for fractures.
A detailed knee examination is performed on the patient who comes in the chronic period, during which specific tests (Lachman test, Anterior Drawer test, pivot-shift test, etc.) are applied for anterior cruciate ligament tear. Sometimes the patient prevents a clear examination result by tightening his/her muscles due to concern about pain.
Meniscus tear is common with anterior cruciate ligament injury. If there is pain and locking, a meniscus tear is suspected. After the examination, index films must be taken. If there is a fracture or crack in the bones forming the joint, it will be seen on the film. A piece of bone may be seen breaking away from the joint surface and falling into the joint. Radiographs are usually normal in anterior cruciate ligament injuries. Sometimes, an adequate examination cannot be performed because the knee is very painful at first. In this case, a second examination within 10 days is diagnostic.
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