Key Points
- ACL injuries occur when you make sudden and fast directional changes or stops, and meniscus injuries occur when your knee rotates while bearing weight.
- When meniscus and cartilage injuries occur at the same time as ACL rupture, you may experience worse outcomes 2-10 years from the time of injury. Hence, it’s important to take steps to prevent these outcomes.
What is an ACL injury?
If you enjoy sports and keeping active, chances are you’re familiar with ACL injuries. The anterior cruciate ligament (ACL) runs diagonally across the centre of the knee, connecting the femur (thighbone) to the tibia (shinbone) and is what allows you to bend your leg. It is crucial in providing rotational stability to the knee, and prevents the tibia from moving out of position in front of the femur.
ACL injuries usually occur when you make sudden and fast directional changes or stops, such as in sports like basketball, skiing, and football. Upon injury, you might hear a ‘pop’ sound, and experience instability and severe pain when trying to put weight on the knee. The knee will swell.
Meniscus injury
Aside from ligaments, cartilage is also crucial for the knee to function properly. Cartilage is rubbery connective tissue that helps cushion the joint, preventing the bones from rubbing against one another. One such example would be the meniscus, a piece of c-shaped cartilage that absorbs shock and stabilises the knee.
Meniscus tears occur when the knee rotates while pressure is being put on it. This can occur in sports that involve pivoting, such as tennis or basketball, or in older persons who are at higher risk of meniscus injuries due to age-related changes. Upon injury, you might experience a popping sensation but may still be able to walk and move. However, after a few days, the knee will swell and stiffen, and may feel like it’s giving out. Cartilage injuries could result from high impact sport injuries, or wear and tear over time.
ACL and meniscus injury
A recent article in the Journal of Orthopaedic & Sports Physical Therapy aimed to look at recovery factors and activity levels after ACL injury, and concluded that meniscus or cartilage injuries at the time of ACL injury were likely to cause worse outcomes 2-10 years after ACL reconstruction such as osteoarthritis.
In fact, in a separate study estimating knee osteoarthritic risk after an ACL and meniscus injury, ACL injuries alone were associated with 4 times higher risk whereas combined ACL and meniscus injuries were associated with 6 times higher risk! As such, it’s important to keep yourself informed on what you can do to prevent osteoarthritis.
How to decide on an ACL surgery?
Delaying ACL reconstruction for too long could decrease the chances for meniscus repair, and cause your ligaments to become loose in the long run. This can put pressure on the cartilage, which can lead to osteoarthritis and cartilage degeneration. To avoid this, it is recommended that ACL reconstruction is carried out within 6 months of your injury.
Physiotherapy after an ACL surgery
It’s not the end of the world if you sustain an ACL injury! Our Physiotherapists can guide you through ways to prevent knee osteoarthritis, such as knee extensor muscle strengthening and maintaining a healthy weight. Exercises such as heavy resistance strength training helps you to regain strength in your quadriceps, not only allowing you to get back to your active lifestyle but also reducing stress on your knee and preventing osteoarthritis in the long run. It’s also important that you can lead the life you want after your injury – our Physiotherapists will also develop a personalised rehabilitation approach that helps you achieve your goals, be it getting back to sports or making trips to the market.
Call us now to schedule an appointment to speak to our Physiotherapist for your ACL injury so that we can help you get on with the sport that you love!
Ref:
Pedersen M, Johnson JL, Grindem H, Magnusson K, Snyder-Mackler L, and Risberg MA.Meniscus or Cartilage Injury at the Time of Anterior Cruciate Ligament Tear Is Associated With Worse Prognosis for Patient-Reported Outcome 2 to 10 Years After Anterior Cruciate Ligament Injury: A Systematic Review. J Orthop Sports Phys Ther 2020;50(9):490-502. Epub 1 Aug 2020. doi:10.2519/jospt.2020.9451
