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    ACL Injury: Everything You Need to Know to Make the Right Treatment Decision: - What the ACL does and why it is so important - Treatment options for partial and complete ACL tears - Surgery: graft options, how it is done, what to expect - How to prepare for surgery - What to d
    ACL Injury: Everything You Need to Know to Make the Right Treatment Decision: - What the ACL does and why it is so important - Treatment options for partial and complete ACL tears - Surgery: graft options, how it is done, what to expect - How to prepare for surgery - What to d
    ACL Injury: Everything You Need to Know to Make the Right Treatment Decision: - What the ACL does and why it is so important - Treatment options for partial and complete ACL tears - Surgery: graft options, how it is done, what to expect - How to prepare for surgery - What to d
    Ebook172 pages2 hours

    ACL Injury: Everything You Need to Know to Make the Right Treatment Decision: - What the ACL does and why it is so important - Treatment options for partial and complete ACL tears - Surgery: graft options, how it is done, what to expect - How to prepare for surgery - What to d

    By Frank Noyes and Sue Barber-Westin

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    About this ebook

    An ACL tear is a common but serious knee injury. The decision of how to treat this injury is not an easy one. It requires understanding the damage in the knee, the treatment options available, and what to expect from these options. Whether you are active in sports or work in a job that requires a strong, stable knee, an ACL tear may have devastating consequences. Two medical professionals have written this eBook to help patients deal with this injury. Dr. Frank Noyes, an internationally renowned orthopaedic surgeon, and Sue Barber-Westin, Director of Clinical Research at the Cincinnati SportsMedicine Research Foundation, provide information that is easy to read and understand. Together, Noyes and Barber-Westin have conducted over 60 clinical studies and published 140 scientific articles. This eBook provides information on what the ACL does and why it is so important, whether to have surgery or not, how to prepare for surgery, and what to do the first week after surgery.
    LanguageEnglish
    PublisherHillcrest Media Group
    Release dateSep 28, 2012
    ISBN9781938008597
    ACL Injury: Everything You Need to Know to Make the Right Treatment Decision: - What the ACL does and why it is so important - Treatment options for partial and complete ACL tears - Surgery: graft options, how it is done, what to expect - How to prepare for surgery - What to d

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      Book preview

      ACL Injury - Frank Noyes and Sue Barber-Westin

      Fixation

      About the Authors

      Dr. Frank Noyes is an internationally recognized orthopaedic surgeon and researcher who has specialized in the treatment of knee injuries and disorders for nearly 4 decades. He is the founder and chairman of the Cincinnati SportsMedicine and Orthopaedic Center and its nonprofit research foundation. Dr. Noyes completed his orthopaedic training at the University of Michigan Medical Center. He then received a 4-year clinical and research appointment as an orthopaedic surgeon in the United States Air Force, was commissioned as a Lieutenant Colonel, and began his landmark research into knee ligament injuries, the effects of immobilization, biomechanics of ligaments, prevention of ACL injuries in the female athlete, the diagnosis of many knee injuries and problems, and the results of treatment for a variety of knee disorders. Along with Dr. Edward Grood, Dr. Noyes established one of the first biomechanics laboratories in the United States at the University of Cincinnati College of Engineering. The laboratory was subsequently named in his honor as the Noyes Tissue Engineering and Biomechanics Laboratory.

      Dr. Noyes has won every conceivable award for his clinical and laboratory research from societies such as the American Academy of Orthopaedic Surgeons, the American Orthopaedic Society of Sports Medicine, the Orthopaedic Research and Education Foundation, as well as the University of Cincinnati. He was inducted into the American Orthopaedic Society for Sports Medicine’s Hall of Fame in 2008. Dr. Noyes has been selected by his peers as one of the Best Doctors in America every year since 1992.

      Dr.Noyes has published over 355 research studies and textbook chapters on many different types of knee injuries and disorders. He edited a textbook entitled, Noyes’ Knee Disorders: Surgery, Rehabilitation, Clinical Outcomes which was written for orthopaedic surgeons, physical therapists, and other sports medicine health care professionals. Dr. Noyes is also a co-editor of ACL Injuries in the Female Athlete. Causes, Impacts, and Conditioning Programs, a textbook written for sports medicine health care professionals, coaches, and trainers involved with female athletes.

      Sue Barber-Westin has directed clinical research studies for Dr. Noyes’ research Foundation for nearly 3 decades. In the mid 1980's, she authored one of the first studies that measured problems during single-leg hopping tests in patients with ACL injuries, Quantitative Assessment of Functional Limitations in Normal and Anterior Cruciate Ligament-Deficient Knees. Sue has co-authored 177 articles and chapters, focusing on the clinical outcome of various knee operative procedures, the methods used to determine the results of clinical investigations, differences in neuromuscular indices between male and female athletes, effects of neuromuscular training in female athletes, and prevention of ACL injuries in female athletes. Sue is the associate editor of Knee Disorders: Surgery, Rehabilitation, Clinical Outcomes and is the co-editor for ACL Injuries in the Female Athlete. Causes, Impacts, and Conditioning Programs. Sue has personally undergone 4 knee operations and played competitive junior and collegiate tennis. In 2004, Sue and Dr. Noyes were members of the research team that won the Clinical Research Award from the Orthopaedic Research and Education Foundation. They are frequently invited to speak at national and international conferences and review articles for orthopaedic and sports medicine journals.

      Sue and Dr. Noyes have written 12 eBooks on a variety of knee and other leg problems. Please visit http://noyeskneebookseries.com/ for further information.

      Introduction

      Chances are, if you have decided to read this eBook, a physician has either told you that you have torn your anterior cruciate ligament (ACL) or you suspect you may have torn your ACL based on your symptoms and what you may have read over the Internet or learned from other people.

      You are certainly not alone! Tears to the ACL are the most common ligament injury that occur in the knee joint. In the United States, an estimated 1 in 3,500 individuals sustain this injury every year. It is believed that approximately 125,000-200,000 ACL reconstructions (operations to fix the ligament damage) are performed in the U.S. annually. Worldwide, it is reasonable to estimate that about 1 million ACL injuries occur every year.

      ACL tears that require surgery most commonly happen in athletes who are less than 25 years of age who frequently play high school, college, or league sports. A recent study that followed 1,841 individuals diagnosed with complete ACL tears reported that the peak incidence of ACL tears occurred between 19 and 25 years of age in males and between 14 and 18 years of age in females. However, ACL injuries occur in athletes of all age groups. Many ACL tears happen when an athlete is cutting, pivoting, accelerating, decelerating, or landing from a jump and do not necessarily involve contact with another player. Fewer injuries are more frightening to an athlete than an ACL tear.

      What is less commonly known is that this injury also happens in the workplace, in automobile accidents, and even during simple daily activities. The impact of an ACL tear to a person who works in construction, forestry, landscaping, law enforcement, or any physically demanding job that requires a stable knee can be devastating. We have treated children as young as 8 years of age and adults in their 60's who have suffered this injury.

      For reasons that scientists are still trying to understand, female athletes have a 4-6 times increased risk of tearing their ACL in certain sports such as soccer and basketball compared with male athletes. As well, women in the military have a significantly higher incidence of ACL tears. We have devoted a great deal of our research efforts into this problem and how to reduce the chance of a female athlete tearing their ACL.

      Unfortunately, many people who injure their ACL also damage other structures in their knee such as the meniscus, joint lining, or other knee ligaments. The costs of treating this injury may be quite high, even with health insurance. An ACL tear may have damaging psychological effects as a result of not being able to play sports or perform normal work activities. Some patients have reported anger, depression, and poor performance in school.

      An ACL tear is certainly a major problem and the decision of how to treat this injury is not an easy one. It requires understanding all of the damage that exists in the knee and all of the treatment options available such as bracing, physical therapy, and surgery.

      Although there is a considerable amount of information available on the Internet about knee injuries, not all comes from medical professionals with the clinical and research knowledge that knee specialists have. For instance, an ACL injury results in either a partial or complete tear to the ligament, and the treatment options and prognosis (what we think will happen in the future) are different depending on the extent of the tear. Surgery is not always required and it is important to understand the positives and potential negative aspects of trying to treat this injury without surgery.

      After treating patients for nearly 4 decades with ACL tears, we decided to write this eBook to try to help individuals understand this injury, the treatment options that are currently available, and what to expect as a result of these options.

      This eBook provides information on basic knee anatomy, what the ACL does and why it is so important, how to find a surgeon, how an ACL tear is diagnosed, the treatment options for partial and complete ACL tears, and advice on what to do if damage has occurred to other parts of the knee. If you decide to have surgery, we also provide information on what type of graft to consider to replace the ACL, what to expect from the operation, how to prepare for the operation, how the operation is performed, and details regarding what to expect and do the first week after surgery.

      The physical therapy programs, both for patients who have surgery and those who choose not to have surgery, are described in our eBook ACL Injury Rehabilitation: Everything You Need to Know to Restore Knee Function and Return to Activity. This eBook also provides advice on what tests patients should pass in order to be released to return to full activities.

      This eBook should not be used for self-diagnosis and treatment of ACL tears. Only a qualified orthopedist or sports medicine-trained physician can make a definitive diagnosis of this injury. For medical professionals, we recommend our textbook Noyes' Knee Disorders. Surgery, Rehabilitation, Clinical Outcomes, 2nd Edition for more comprehensive information regarding the diagnosis and treatment of ACL injuries. Fourteen chapters are included that detail knee anatomy, examination and classification of knee ligament injuries, biomechanics of ACL grafts, operative techniques, rehabilitation programs, and neuromuscular training to prevent ACL injuries.

      Basic Knee Anatomy

      The knee is a hinge joint. It is made up of 4 bones that are held together by ligaments, tendons, and muscles. The femur (or thigh bone) is the large bone in the thigh. The tibia (or shin bone) is the large bone in the lower leg and the fibula is the smaller bone in the lower leg that lies parallel to the tibia. The patella (or knee cap) is the small bone in the front of the knee that glides up and down as the knee bends and straightens. It is located in front of the femur and glides through a groove called the trochlear (or patellar or femoral) groove.

      Basic knee anatomy

      There are 2 joints, or articulations, in the knee. The tibiofemoral joint is the area where the femur and tibia meet. The patellofemoral joint is the

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