Olympic Medicine: ACL Tears

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As the 2024 Paris Summer Olympics unfold, medicine.net continues to provide you with valuable medical insights.

Many well-known athletes have experienced ACL (anterior cruciate ligament) tears. Although they often return to competition after treatment, their physical condition usually isn’t the same as before the injury.

What is the ACL? Also known as the cruciate ligaments, these are two ligaments in the knee joint that cross each other in the shape of a cross. They consist of the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). Together, these ligaments play a crucial role in stabilizing the knee joint. The ACL primarily prevents the tibia from moving too far forward and from excessive rotation, while the PCL mainly stops the tibia from moving backward. The primary purpose of both ligaments is to maintain knee stability, with ACL injuries being more common among athletes.

An ACL tear is a severe injury to the cruciate ligaments, and both the ACL and PCL can be affected. When the ACL tears, it is often accompanied by a "popping" sound, followed by pain, swelling, and limited range of motion in the knee. PCL tears also cause knee pain and swelling, but their symptoms are generally less severe than those of ACL tears.

Surgery is the preferred treatment for an ACL tear due to the significant impact this injury has on a person’s daily life and activities. With advances in surgical techniques, most ACL surgeries are now performed using arthroscopic methods. Typically, the surgery involves using a graft from the patient’s own tendons, such as the patellar tendon, hamstring tendons, or quadriceps tendon, to replace the torn ligament. Donor tendons can also be used. Post-surgery, patients need to undergo a series of rehabilitation exercises to aid recovery. Recovery from a PCL tear may be more complex and prolonged.

However, not everyone requires surgery. Many elderly individuals, due to their frail health and low activity levels, and some patients with other health conditions, may opt for non-surgical treatment.

Non-surgical treatment mainly involves providing external support and protection to the knee joint through physical devices. Since a ligament tear is a very painful injury, non-steroidal anti-inflammatory drugs (NSAIDs) or other pain medications are used to control pain and inflammation. Although conservative non-surgical treatment may not restore a patient’s original athletic ability, it is often the best choice for those whose health does not allow for surgery.

The cruciate ligaments are vital for us, so it’s important to warm up adequately before exercising and to understand our physical limits to avoid overexertion. To maintain our health, we must protect our bodies from injury and the pain that comes with it!