In sports that place great pressure on the knees, especially with twisting forces, it is common to tear one or more ligaments or cartilages. An increasingly common victim to injury is the anterior cruciate ligament, often torn as a result of a rapid direction change while running or some other, violent twisting motion. It can also be torn by extending the knee forcefully beyond its normal range. In some such cases, other structures incur damage as well. Especially debilitating is the unfortunately common "unhappy triad" of torn medial collateral and anterior cruciate ligaments and a torn medial meniscus. This typically arises from a combination of inwards forcing and twisting.
Before the advent of arthroscopy and arthroscopic surgery, patients having surgery for a torn ACL required at least nine months of rehabilitation.
In addition to developing new surgical procedures, ongoing research is looking into underlying problems which may increase the likelihood of an athlete suffering a severe knee injury. These findings may lead to effective preventive measures, especially in female athletes, who have been shown to be especially vulnerable to ACL tears from relatively minor trauma. Several diagnostic manoeuvres help clinicians diagnose an injured ACL. In the anterior drawer test, the examiner applies an anterior force on the proximal tibia with the knee in 90 degrees of flexion. The Lachman test is similar, but performed with the knee in only about twenty degrees of flexion, while the pivot-shift test adds a valgus (outside-in) force to the knee while it is moved from flexion to extension. Any abnormal motion in these manoeuvres suggests a tear.
The diagnosis is usually confirmed by MRI, the availability of which has greatly lessened the number of purely diagnostic arthroscopies performed.
Find out how much your knee injury can get you by calling MAXIMUMJUSTICE on 0131 268 6991 .