Materiały źródłowe

• #1 ACL injury – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acl-injury/diagnosis-treatment/drc-20350744

  During ACL injury treatment, prompt first-aid care can reduce pain and swelling immediately after an injury to your knee. Follow the R.I.C.E. model of self-care at home: Rest. General rest is necessary for healing and limits weight bearing on your knee. Ice. When you’re awake, try to ice your knee at least every two hours for 20 minutes at a time. Compression. Wrap an elastic bandage or compression wrap around your knee. Elevation. Lie down with your knee propped up on pillows. […] Medical treatment for an ACL injury begins with several weeks of rehabilitative therapy. A physical therapist will teach you exercises that you will perform either with continued supervision or at home. You may also wear a brace to stabilize your knee and use crutches for a while to avoid putting weight on your knee. The goal of rehabilitation is to reduce pain and swelling, restore your knee’s full range of motion, and strengthen muscles. This course of physical therapy may successfully treat an ACL injury for individuals who are relatively inactive, engage in moderate exercise and recreational activities, or play sports that put less stress on the knees.

• #2 ACL Surgery > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/acl-surgery

  Surgery is arthroscopic, meaning it involves several small incisions. […] The goal is to help patients navigate all aspects of this injury, including ACL surgery, to allow them to return safely to their desired activities and regain their quality of life. […] There are two treatment options for ACL injury: Nonsurgical treatment such as a brace to protect from instability and physical therapy to strengthen the surrounding ligaments to provide greater stability […] Surgical reconstruction of the ACL to restore the internal structures of the knee to enable maximal stability. […] Patients usually choose ACL surgery (or reconstruction) if they want to continue their sport or other activity, or if they are younger and want to prevent or prolong the time until they develop arthritis in the area.

• #2 ACL Tear & Injury: Symptoms & Recovery

  https://my.clevelandclinic.org/health/diseases/16576-acl-tear

  The recovery time for a torn ACL is usually six to nine months. […] Treatments can vary depending on your ACL tear grade and any other damage inside your knee. […] Follow the RICE method as soon as you notice pain or other symptoms: Rest: Avoid the activity that caused your injury. […] Your provider will suggest treatments to manage your pain and other symptoms. You might need: Crutches. […] A torn ACL can’t heal on its own, but it’s possible to live with it (especially if you have a low-grade tear). […] Most people choose to have an ACL tear surgically repaired. […] Surgery to repair damage in your knees is usually an outpatient procedure, which means you can go home the same day. […] Rehabilitation after your surgery is the best way to restore your knee’s strength and flexibility. […] If you need surgery to repair your ACL, you should be able to return to the field or court as soon as your knee has healed.

• #3 Nonsurgical Treatment for Anterior Cruciate Ligament Tears | NYU Langone Health

  https://nyulangone.org/conditions/anterior-cruciate-ligament-tears/treatments/nonsurgical-treatment-for-anterior-cruciate-ligament-tears

  NYU Langone physicians may recommend nonsurgical treatment for an anterior cruciate ligament (ACL) injury, from immediate strategies for reducing inflammation to ongoing physical and occupational therapy to strengthen and support the knee. […] These therapies may be an option for people who are not candidates for ACL reconstruction or repair surgery because of an underlying condition, or for those who do not routinely put a lot of stress on their knee joint through pivoting or contact sports. […] Using rest, ice, compression, and elevation, also known as the RICE regimen, as soon as possible after injuring your knee can help reduce pain and swelling. […] Your doctor may suggest using crutches to keep weight off your knee or a knee brace to protect the joint from instability for a couple of weeks.

• #4 ACL Tear Treatment Options

  https://www.sports-health.com/sports-injuries/knee-injuries/acl-tear-treatment-options

  Both nonsurgical and surgical treatment options may be used to treat anterior cruciate ligament (ACL) knee injuries. Although surgery is sometimes necessary, not everyone who has an ACL injury is a candidate for surgery. […] Immediately after the injury, management consists of the RICE method: Rest. Activities that cause knee pain, such as running or walking for long periods of time, should be avoided until symptoms are relieved. Ice. A person may be advised to apply ice packs to the area to help reduce pain and swelling. Ice packs can be applied several times throughout the day for about 10 to 20 minutes at a time. Compression. Swelling can be managed by wearing a tight, elastic bandage around the affected knee. Elevation. Keeping the knee supported above the waist may help with swelling.

• #5 Anterior Cruciate Ligament Knee Injury – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499848/

  The anterior cruciate ligament is one of the two cruciate ligaments that aids in stabilizing the knee joint. It is the most commonly injured ligament in the knee, commonly occurring in football, soccer, and basketball players. Treatment consists of the RICE therapy, which includes rest, ice, compression of the affected knee, and elevation of the affected lower extremity. This activity describes the evaluation and management strategies for such injuries and stresses the role of team-based interprofessional care for patients with anterior cruciate ligament injuries. […] Acute treatment consists of the „RICE” therapy, which includes rest, ice, compression of the affected knee, and elevation of the affected lower extremity. Patients should be non-weight bearing and may utilize crutches or a wheelchair if necessary. Pain relief can be achieved with over-the-counter medications such as NSAIDs but is typically at the treating physician’s discretion.

• #6 ACL Injury: Diagnosis & Treatment | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/knee/acl-injuries/treatment

  Your doctor is more likely to recommend surgery to reconstruct or repair the damaged ligament if you’re an athlete who relies on your strength and agility to perform. […] The ACL has limited blood supply and can’t usually heal by itself. Because of that, complete tears might require surgery if you continue to feel instability in the knee with physical activity. […] Mild ACL injuries may heal without surgery, following an ACL injury self-care plan similar to your recovery plan after surgery. […] Whether you require surgery to fix your ACL or not, you will need to follow a rehabilitation program to heal from your injury: Resting gives the structures in your knee time to heal and regain weight-bearing strength. Icing and elevating your knee multiple times a day reduces inflammation and swelling. Pain and anti-inflammatory medications can help to reduce swelling and pain. Regular physical therapy can strengthen the muscles in your knee and recover a full range of motion. You may use a sports brace, which can provide compression and extra stability during physical activity.

• #7 Treatment After Anterior Cruciate Ligament Injury: Panther Symposium ACL Treatment Consensus Group

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7315684/

  Treatment strategies for anterior cruciate ligament (ACL) injuries continue to evolve. […] An international consensus group of experts was convened to collaboratively advance toward consensus opinions regarding the best available evidence on operative versus nonoperative treatment for ACL injury. […] In highly active patients engaged in jumping, cutting, and pivoting sports, early anatomic ACL reconstruction is recommended because of the high risk of secondary meniscal and cartilage injuries with delayed surgery, although a period of progressive rehabilitation to resolve impairments and improve neuromuscular function is recommended. […] For patients who seek to return to straight-plane activities, nonoperative treatment with structured, progressive rehabilitation is an acceptable treatment option.

• #8 Treatment After Anterior Cruciate Ligament Injury: Panther Symposium ACL Treatment Consensus Group

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7315684/

  However, with persistent functional instability, or when episodes of giving way occur, anatomic ACL reconstruction is indicated. […] Successful outcomes after both operative and nonoperative treatments necessitate progressive rehabilitation, which entails staged and phase-adjusted physical therapy with the aim to address impairments, achieve functional stability, and safely return to sport. […] Any discussion of nonoperative treatment within this consensus document implies the completion of a progressive, staged rehabilitation protocol. […] Similarly, any discussion of operative treatment implies anatomic ACL reconstruction. […] Comprehensive rehabilitation after operative ACL reconstruction is also paramount for clinical outcome and return to sport. […] There is still uncertainty as to which patients should undergo immediate surgery and which patients may be successfully treated nonoperatively.

• #9 Non-surgical ACL Tear or Injury Treatments: What to Expect

  https://www.upmc.com/services/orthopaedics/services/sports-medicine/services/acl/treatment/non-surgical

  ACL injuries don’t always need surgery. When people have minor ACL injuries, doctors may suggest a nonsurgical ACL injury treatment. Nonsurgical approaches may also be best for older adults and people at a higher risk of surgery complications. […] Immediately after an ACL injury, it’s important to rest and reduce swelling, which can damage other parts of the knee joint. Reducing swelling is key, whether you need nonsurgical or surgical treatment. […] Most people can start physical therapy as soon as their swelling and pain improve. […] Your doctor may recommend a brace that keeps your knee in a bent position for several weeks. After this, you can gradually increase movement with the help of a physical therapist. […] Those who may benefit from nonsurgical treatment for an ACL injury include people who have a more minor ACL injury, like an ACL that’s overstretched rather than torn.

• #10 ACL Injury Treatment: Exploring Surgical and Non-Surgical Options – Professional Physical Therapy

  https://www.professionalpt.com/acl-injury-treatment-exploring-surgical-and-non-surgical-options-blog/

  Anterior cruciate ligament (ACL) injuries are among the most common injuries, especially in high-impact sports such as football, basketball, skiing, and soccer. […] Deciding whether to undergo surgery or pursue non-surgical treatment for an ACL tear depends on various factors, including the severity of the injury, activity level, and personal goals. […] If you only tear the ACL partially, you may not need surgery. For some individuals, non-surgical treatment is a viable option that can help it heal. This approach focuses on managing symptoms, restoring knee function, and improving stability through conservative means. […] Physical therapy plays a central role in the non-surgical management of ACL injuries. A well-structured rehabilitation program focuses on: […] Even for those who choose surgery, physical therapy is crucial both before and after the procedure to optimize recovery and improve outcomes.

• #11 ACL Injury: Does It Require Surgery? – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/treatment/acl-injury-does-it-require-surgery/

  Nonsurgical management of isolated ACL tears is likely to be successful or may be recommended: For patients with partial tears and no instability symptoms; For patients with complete tears who don’t experience symptoms of knee instability during low-demand sports and are willing to give up high-demand sports; For patients who do light manual work or live sedentary (inactive) lifestyles. […] ACL tears are not usually repaired using sutures (stitches) because repaired ACLs have generally been shown to fail over time. […] Therefore, the torn ACL is generally replaced by a substitute graft made of tendon, including: Patellar, hamstring, or quadriceps tendon autograft (autografts come from the patient); Patellar tendon, Achilles tendon, semitendinosus, gracilis, or posterior tibialis tendon allograft (allografts come from a tissue donor).

• #12 Patient education: Anterior cruciate ligament injury (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/anterior-cruciate-ligament-injury-beyond-the-basics

  ANTERIOR CRUCIATE LIGAMENT INJURY TREATMENT […] Anterior cruciate ligament (ACL) injuries are treated with surgery and post-surgical rehabilitation or a non-surgical rehabilitation program. The decision to have surgery is based upon several factors, including your age, how active you are, and whether you have other knee injuries. When deciding whether to have surgery, it’s also important to think about how the recovery process will impact your life. […] You may choose to have surgery if you: […] Participate in high-level sports or have a job that requires a strong and stable knee (eg, requires twisting and pivoting) […] Are unsteady when standing on the injured knee […] Have multiple injuries (eg, meniscal tear and ACL tear) […] Have completed rehabilitation and still have instability in the knee

• #13 Patient education: Anterior cruciate ligament injury (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/anterior-cruciate-ligament-injury-beyond-the-basics

  Are willing to complete the rigorous post-surgical rehabilitation program. Most programs require daily strengthening and stretching exercises and one or more weekly visits with a physical therapist for the first three to six months after surgery. Failure to follow this program could increase the risk of re-injury, allow scar tissue to develop, and lead to limited movement of the knee. […] You may decide not to have surgery if you: […] Have a small partial tear in the ACL that may heal with rest and rehabilitation […] Do not participate in sports that require pivoting or stopping quickly, especially if you are older than 55 years […] Are willing to complete a non-surgical rehabilitation program to strengthen and stabilize the knee. […] If you do not have surgery to reconstruct your ACL, you may be at an increased risk of future knee problems, including chronic pain, a decreased level of activity, and injury to other parts of the knee (the meniscus). However, surgery is also not a „quick fix,” as it involves a challenging recovery period and requires committing to a rigorous rehabilitation program.

• #14 ACL injury – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acl-injury/diagnosis-treatment/drc-20350744

  Your doctor may recommend surgery if: You’re an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting. More than one ligament or the fibrous cartilage in your knee also is injured. The injury is causing your knee to buckle during everyday activities. During ACL reconstruction, the surgeon removes the damaged ligament and replaces it with a segment of tendon tissue similar to a ligament that connects muscle to bone. This replacement tissue is called a graft. After surgery you’ll resume another course of rehabilitative therapy. Successful ACL reconstruction paired with rigorous rehabilitation can usually restore stability and function to your knee. There’s no set time frame for athletes to return to play. Recent research indicates that up to one-third of athletes sustain another tear in the same or opposite knee within two years. A longer recovery period may reduce the risk of re-injury. In general, it takes as long as a year or more before athletes can safely return to play. Doctors and physical therapists will perform tests to gauge your knee’s stability, strength, function and readiness to return to sports activities at various intervals during your rehabilitation. It’s important to ensure that strength, stability and movement patterns are optimized before you return to an activity with a risk of ACL injury.

• #15 ACL Surgery > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/acl-surgery

  Surgery is arthroscopic, meaning it involves several small incisions. […] The goal is to help patients navigate all aspects of this injury, including ACL surgery, to allow them to return safely to their desired activities and regain their quality of life. […] There are two treatment options for ACL injury: Nonsurgical treatment such as a brace to protect from instability and physical therapy to strengthen the surrounding ligaments to provide greater stability […] Surgical reconstruction of the ACL to restore the internal structures of the knee to enable maximal stability. […] Patients usually choose ACL surgery (or reconstruction) if they want to continue their sport or other activity, or if they are younger and want to prevent or prolong the time until they develop arthritis in the area.

• #16 Treatment After Anterior Cruciate Ligament Injury: Panther Symposium ACL Treatment Consensus Group

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7315684/

  A screening tool to differentiate potential copers from noncopers was developed and included a combination of hop tests, questionnaires on general knee function, and the frequency of giving-way episodes. […] The treatment approach should be determined through a shared decision-making process between the patient and the provider. […] The current body of evidence regarding the treatment of ACL injury is to a large extent based on low-level evidence. […] The expert panel at the ACL Consensus Meeting Panther Symposium 2019 reached consensus, defined as 80% agreement, on 11 of 12 statements in terms of operative versus nonoperative treatment for ACL injuries. […] In active patients wishing to return to jumping, cutting, and pivoting sports, operative treatment is the preferred option to maintain athletic participation in the medium to long term. […] In active patients wishing to return to straight-plane activities, nonoperative treatment is an option. […] If during the nonoperative treatment subjective instability persists or episodes of giving way occur, referral for consideration of anatomic ACL reconstruction is recommended.

• #17 ACL injury – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acl-injury/symptoms-causes/syc-20350738

  Depending on the severity of your ACL injury, treatment may include rest and rehabilitation exercises to help you regain strength and stability, or surgery to replace the torn ligament followed by rehabilitation. […] Proper training and exercise can help reduce the risk of ACL injury. […] Programs to reduce ACL injury include: […] Training to strengthen muscles of the legs, hips and core as well as training to improve jumping and landing techniques and to prevent inward movement of the knee may help to reduce the higher ACL injury risk in female athletes. […] Wearing a knee brace doesn’t appear to prevent ACL injury or reduce the risk of recurring injury after surgery.

• #18 ACL Rehabilitation and Physical Therapy

  https://www.upmc.com/services/orthopaedics/services/sports-medicine/services/acl/treatment/rehabilitation

  Whether choosing a surgical or nonsurgical approach to ACL treatment, physical therapy is vital to healing after an ACL injury. […] Before surgery, doctors often prescribe physical therapy prehabilitation to help: Improve strength in the muscles around the knee. Reduce swelling in the knee. Restore, as close as possible, the normal range of motion in the knee. […] When it comes to ACL rehab after surgery, there are three main treatment goals your surgeon and physical therapist will work toward: Stabilizing the knee if it’s unsteady, to help you return to your daily routine. Strengthening the muscles that support your knee, to help you get to the same level of activity as before your injury. Reducing the risk that you will reinjure your knee when you return to sports. […] UPMC Sports Medicines science-based approach to rehab from ACL injury has five phases. The length of each phase will depend on your treatment goals.

• #19 ACL Rehabilitation and Physical Therapy

  https://www.upmc.com/services/orthopaedics/services/sports-medicine/services/acl/treatment/rehabilitation

  Whether choosing a surgical or nonsurgical approach to ACL treatment, physical therapy is vital to healing after an ACL injury. […] Before surgery, doctors often prescribe physical therapy prehabilitation to help: Improve strength in the muscles around the knee. Reduce swelling in the knee. Restore, as close as possible, the normal range of motion in the knee. […] When it comes to ACL rehab after surgery, there are three main treatment goals your surgeon and physical therapist will work toward: Stabilizing the knee if it’s unsteady, to help you return to your daily routine. Strengthening the muscles that support your knee, to help you get to the same level of activity as before your injury. Reducing the risk that you will reinjure your knee when you return to sports. […] UPMC Sports Medicines science-based approach to rehab from ACL injury has five phases. The length of each phase will depend on your treatment goals.

• #20 ACL Tear Repair | Torn ACL | Duke Health

  https://www.dukehealth.org/treatments/orthopaedics/torn-acl

  Bridge-enhanced ACL repair (BEAR) is a new FDA-approved procedure that allows a torn ACL to heal itself and does not require graft tissue to be taken from another part of the body. […] You will start knee-specific physical therapy immediately. Physical „prehab” prepares your knee for ACL surgery and ensures you have a faster recovery. […] After surgery, your physical therapists work on strength and conditioning of your knee. Functional movement screening, developed at Duke, gives your doctor objective measurements of your recovery and helps them determine when you can safely return to your normal activities. This minimizes the risk of re-injury. […] Duke knee specialists include primary care sports medicine specialists, orthopaedic physician assistants, ACL surgeons, and physical therapists who specialize in knee injuries associated with specific sports.

• #21 ACL Surgery > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/acl-surgery

  ACL reconstruction is typically an outpatient procedure. […] The procedure is arthroscopic, which means it involves several small incisions and the insertion of a tiny camera and instruments to allow the surgeon to see inside the knee joint and to perform the operation. […] Following instructions for physical therapy and rehabilitation is imperative. […] The decision of when to return to sports and unrestricted activities requires collaboration between the patient, the surgeon, and the physical therapist. […] The success rate for ACL surgery done correctly and with proper rehabilitation is very high.

• #22 Anterior Cruciate Ligament Knee Injury – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499848/

  Surgical technique: arthroscopically assisted; preparation of the graft bed is either by clearance of the native ACL remnants completely or by leaving the stump as guidance for tunnel positioning and augmenting healing; there are no reported differences between these approaches. […] ACL repair: There has been a resurgence in ACL repair techniques, especially in the pediatric population. Multiple techniques are used, including dynamic intra-ligamentary stabilization (DIS), internal brace ligament augmentation (IBLA), and biological enhancement, such as bridge-enhanced ACL repair (BEAR). The 2-year outcomes show comparable results. […] Revision of ACL reconstruction is indicated in failed cases with instability affecting the desired activities. When considering a revision, the underlying etiology of the re-rupture must be identified, along with an assessment of any missed concomitant injuries. Other considerations include previous graft selection and considering stronger grafts, e.g., quadriceps tendon, hamstrings, or allografts.

• #23 Patient education: Anterior cruciate ligament injury (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/anterior-cruciate-ligament-injury-beyond-the-basics

  Surgical reconstruction of the ACL is usually done in a hospital or surgical center. Most people are given general anesthesia to induce sleep and prevent pain. The surgery itself usually takes less than two hours. […] To reconstruct the torn ligament, a piece of healthy tendon, called an autograft, is removed or „harvested” from another area in the leg. There are several common autograft sites, including the patellar tendon, hamstring tendon, or rarely the quadriceps tendon. Another option is to use a tendon from a deceased donor, called an allograft. No one type of graft has been proven to be better than another. Thus, the type of graft that is used depends upon the surgeon’s preference and experience. […] The torn ACL is removed and replaced with the graft using a narrow telescope-like device, called an arthroscope. The scope contains a camera and light source, and can be inserted into the knee joint through a small skin incision. Instruments are inserted into other small incisions, allowing the physician to place the graft with precision. After the graft is secured, the knee is wrapped with sterile dressings and an immobilizer is placed around the knee to allow the person to walk more easily with crutches.

• #24

  https://www.orthobullets.com/knee-and-sports/3008/acl-tear

  High tibial osteotomy or distal femoral osteotomy indications limb malalignment in both the coronal and sagittal plane must be addressed before or at the same time as ligament reconstruction. […] Outcomes high ACL failure rates in unaddressed limb malalignment. […] Physical therapy, lifestyle modifications technique early symptomatic treatment followed by 3 months of supervised physical therapy. […] ACL reconstruction goal is to anatomically reconstruct ligament to restore anterior and rotational stability. […] Graft selection Bone-patellar tendon-bone (BPTB) autograft advantages of all autografts using patient’s own tissue. […] Quadrupled hamstring autograft pros and cons smaller incision, less perioperative pain, less anterior knee pain. […] Allograft useful in revisions, no harvest site morbidity, longer incorporation time.

• #25 ACL Injuries: Treatment for a Tear of the Anterior Cruciate Ligament | Brown University Health

  https://www.brownhealth.org/be-well/acl-injuries-treatment-tear-anterior-cruciate-ligament

  Following surgery, typical recovery time for full athletic return is six to nine months, with rehabilitation a key focus of your recovery. […] Orthopedic surgeons are now testing a new technique in surgical repair of ACL injuries known as BEAR (Bridge-Enhanced ACL Restoration). Rather than using a tendon from another part of the body to reconstruct the torn ACL, surgeons can now use a special device along with sutures and stitches to reconnect the ligament and allow it to heal itself.

• #26 ACL Injury Treatment – Herlong Sports PT

  https://herlongsportspt.com/injury-treatments/leg-foot/acl-injury-treatment/

  In the world of sports, ACL injuries are infamous among athletes, parents, and coaches alike and for good reason: the typical rehab timeline for return to 100% health from a complete ACL tear is typically around 9-12 months, if recovery goes smoothly. […] With proper ACL injury treatment through physical therapy, you can get back to the field, court, or ice as strong as ever. […] ACL reconstruction surgery is strongly encouraged for individuals engaged in high-level cutting and pivoting sports to maximize their return to high-level competition. […] Prehab (pre-surgery rehabilitation) is also strongly recommended in order to go into surgery with a quiet knee minimal swelling, full range of motion, and close to full strength compared to the uninvolved knee to maximize outcomes post-surgery.

• #27 ACL Tear Repair | Torn ACL | Duke Health

  https://www.dukehealth.org/treatments/orthopaedics/torn-acl

  Bridge-enhanced ACL repair (BEAR) is a new FDA-approved procedure that allows a torn ACL to heal itself and does not require graft tissue to be taken from another part of the body. […] You will start knee-specific physical therapy immediately. Physical „prehab” prepares your knee for ACL surgery and ensures you have a faster recovery. […] After surgery, your physical therapists work on strength and conditioning of your knee. Functional movement screening, developed at Duke, gives your doctor objective measurements of your recovery and helps them determine when you can safely return to your normal activities. This minimizes the risk of re-injury. […] Duke knee specialists include primary care sports medicine specialists, orthopaedic physician assistants, ACL surgeons, and physical therapists who specialize in knee injuries associated with specific sports.

• #28 What Are the Top Treatments for an ACL Injury?

  https://www.performanceorthosports.com/blog/what-are-the-top-treatments-for-an-acl-injury-42121.html

  An Internal Brace is another adjunct to ACL Reconstruction Surgery. In the early phases of healing, the ACL is fragile and vulnerable to reinjury. This technique involves adding an internal support adjacent to the ACL to reduce stress on the graft while its healing. […] A relatively new procedure, BEAR uses a bioengineered scaffold to facilitate the healing of the torn ACL. The scaffold is placed between the torn ends of the ACL and is infused with the patients blood to promote natural ligament healing. This method aims to restore the ACL without needing a graft. This technique is experimental but has shown early promise for the future. […] Consult with Dr. Milan DiGiulio, an Orthopaedic Sports Medicine specialist to determine the best course of action for your injury.

• #29 ACL Rehabilitation and Physical Therapy

  https://www.upmc.com/services/orthopaedics/services/sports-medicine/services/acl/treatment/rehabilitation

  Whether choosing a surgical or nonsurgical approach to ACL treatment, physical therapy is vital to healing after an ACL injury. […] Before surgery, doctors often prescribe physical therapy prehabilitation to help: Improve strength in the muscles around the knee. Reduce swelling in the knee. Restore, as close as possible, the normal range of motion in the knee. […] When it comes to ACL rehab after surgery, there are three main treatment goals your surgeon and physical therapist will work toward: Stabilizing the knee if it’s unsteady, to help you return to your daily routine. Strengthening the muscles that support your knee, to help you get to the same level of activity as before your injury. Reducing the risk that you will reinjure your knee when you return to sports. […] UPMC Sports Medicines science-based approach to rehab from ACL injury has five phases. The length of each phase will depend on your treatment goals.

• #30 ACL Rehabilitation and Physical Therapy

  https://www.upmc.com/services/orthopaedics/services/sports-medicine/services/acl/treatment/rehabilitation

  The first two months of rehab are crucial to the healing process after ACL surgery. […] Based on how severe your ACL injury was, you should attend PT at your local rehab center one to three times a week. You should also practice your exercises at home. […] Based on your progress, you’ll start running as early as four months after ACL surgery. […] Five to eight months after ACL surgery, your doctor and physical therapist will see if you’re ready for jumping. […] Six to nine months post ACL surgery, you’ll start drills that focus on single-leg jumps and landings, and sport-specific cutting. […] The last phase of rehab takes place nine to 12 months after surgery. The focus of this phase is to steadily add sports movements at slow speeds and then faster speeds. […] When rehabbing from ACL surgery, your physical therapist will include drills at each phase of recovery that will help: Strengthen your injured leg. Achieve full range of motion in your knee. Increase flexibility, coordination, and agility.

• #31 ACL Injury: Does It Require Surgery? – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/treatment/acl-injury-does-it-require-surgery/

  Active adult patients who are involved in sports or jobs that require pivoting, turning, or hard-cutting, or who perform heavy manual work are encouraged to consider surgical treatment. […] In young children or adolescents with ACL tears, early ACL reconstruction creates a possible risk of growth plate injury, leading to bone growth problems. […] A patient with a torn ACL and significant functional instability has a high risk of developing damage in other areas of the knee and should therefore consider ACL reconstruction. […] The goals for rehabilitation of ACL reconstruction include: Reducing knee swelling; Maintaining mobility of the kneecap to prevent anterior knee pain problems or stiffness; Regaining full range of motion of the knee; Strengthening the quadriceps and hamstring muscles.

• #32 What happens during physical therapy for an ACL injury?

  https://www.riversideonline.com/en/patients-and-visitors/healthy-you-blog/blog/w/what-happens-during-physical-therapy-for-an-acl-injury

  If youre still in pain or your knee sometimes feels unstable after several weeks of physical therapy, or you choose to have surgery right away, physical therapy will begin the day after surgery. […] The first goal is to return to a full range of motion while also getting the swelling and pain under control. […] In the beginning, physical therapists focus on strengthening the quad (thigh) muscles, which become very weak after surgery. Therapy will also include stretches and working to regain the ability to walk and go up and down stairs without an assistive device like crutches. […] After ACL surgery, athletes need at least six months before returning to sports. While it depends on the patient, we try and keep athletes in physical therapy for six to nine months, says Moore. But for people who just want to go to work and play with their kids, and they’re not interested in doing anything too strenuous, heir rehabilitation may be completed in about four or five months.

• #33 Patient education: Anterior cruciate ligament injury (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/anterior-cruciate-ligament-injury-beyond-the-basics

  You will probably need to wear a brace that keeps your leg straight for at least two weeks after surgery. This brace protects your knee, but many surgeons recommend removing it to do gentle range-of-motion exercises (with a CPM machine) beginning about three to five days after surgery. Stretching and strengthening exercises can usually begin within the first few days after surgery. […] Post-surgical rehabilitation — Most people who have ACL reconstruction will be under the care of a surgeon and physical therapist who will work together to design a rehabilitation program. The rehabilitation process is difficult, and it can be frustrating to have to rebuild your muscles and learn to walk again after your injury. Your knee will likely feel stiff for some time as you work to regain normal range of motion.

• #34 Patient education: Anterior cruciate ligament injury (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/anterior-cruciate-ligament-injury-beyond-the-basics

  The following rehabilitation schedule is an example of one that your team may recommend: […] First phase — During the first two weeks after surgery, the goal is to increase your range of motion (flexing and extending the knee), maintain strength, minimize the development of scar tissue, and eliminate swelling. Most people begin to walk without crutches by the end of the first week. You should apply ice and elevate your knee daily to minimize swelling. […] Second phase — Between the third and twelfth weeks after surgery, the goal is to improve range of motion, strength, walking, and balance. Most people are allowed to walk or use an exercise bike for 15 to 20 minutes per day. […] Third phase — Four or more months after surgery, the difficulty and intensity of the exercises described above should be continued. In addition, you will likely be able to resume exercises that include jumping and landing.

• #35 ACL Rehabilitation and Physical Therapy

  https://www.upmc.com/services/orthopaedics/services/sports-medicine/services/acl/treatment/rehabilitation

  The first two months of rehab are crucial to the healing process after ACL surgery. […] Based on how severe your ACL injury was, you should attend PT at your local rehab center one to three times a week. You should also practice your exercises at home. […] Based on your progress, you’ll start running as early as four months after ACL surgery. […] Five to eight months after ACL surgery, your doctor and physical therapist will see if you’re ready for jumping. […] Six to nine months post ACL surgery, you’ll start drills that focus on single-leg jumps and landings, and sport-specific cutting. […] The last phase of rehab takes place nine to 12 months after surgery. The focus of this phase is to steadily add sports movements at slow speeds and then faster speeds. […] When rehabbing from ACL surgery, your physical therapist will include drills at each phase of recovery that will help: Strengthen your injured leg. Achieve full range of motion in your knee. Increase flexibility, coordination, and agility.

• #36 ACL Rehabilitation Phase 1 | MOON Knee ACL Research

  https://acltear.info/anterior-cruciate-ligament-rehabilitation/acl-rehabilitation-phase-1/

  The evidence-based MOON Knee Group anterior cruciate ligament post-surgery rehabilitation program has five phases. Each has specific goals, exercises and instructions based on two decades of research. […] Success depends on completing each phase before moving on the next. Your physician, physical therapist or athletic trainer will measure your progress and instruct you on when to advance. […] Gaining full knee extension (straightness) is a critical goal in Phase 1. […] The Quadriceps Set is vital in restoring your quadriceps strength. It is also the foundation for many other exercises as you progress. […] You have four hamstring muscles along the back of each thigh. These help control the knee with many activities including walking and stairs. Restoring hamstring strength is just as important as it is for the quadriceps on the front of your thigh.

• #37

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=ug2544

  When you have an ACL injury, you lose leg strength and motion. You also lose stability in your knee. It’s important to get back your leg strength and motion as soon as you can, whether you choose to have surgery or not. Exercises to get back your muscle strength and knee motion should begin before you start treatment, whether treatment is a rehabilitation (rehab) program only or surgery plus rehab. […] If you do exercises to strengthen your thigh muscles (quadriceps and hamstrings) and get back your knee motion soon after your injury, you will be better prepared for a rehab program or for surgery and a rehab program. […] Your doctor may want you to tailor exercises to your specific injury. Check with your doctor before you do any exercises. […] When you can do this exercise with ease and no pain, add some resistance. […] It’s a good idea to repeat these steps with your other leg. […] It’s a good idea to repeat these steps with your other leg. […] It’s a good idea to repeat these steps with your other leg. […] It’s a good idea to repeat these steps on your other side.

• #38 ACL Rehabilitation and Physical Therapy

  https://www.upmc.com/services/orthopaedics/services/sports-medicine/services/acl/treatment/rehabilitation

  During rehab from ACL reconstruction, you’ll learn: Agility grids. Box jumps. Deadlifts and bridges. Heel slides. Ladder drills. Planks and side-planks. Quad sets. Squats and lunges. Straight-leg raises. […] Talk to your knee surgeon and physical therapist on how to best progress through each phase of ACL rehab.

• #39 12 Exercises for ACL (Anterior Cruciate Ligament) Rehab

  https://www.verywellhealth.com/acl-rehab-exercises-3119304

  These exercises can be done at home, ideally with the input of your doctor or physical therapist. They can help prepare you for ACL surgery, or complement your structured rehabilitation program. […] When first starting, forget the adage „no pain, no gain.” You will probably feel discomfort when exercising the quads and hams, but stop if a movement causes outright pain. Pushing too hard can make your injury worse and may result in lengthier recovery time. […] An ACL injury happens when you overstretch or tear the ACL ligament in the knee. You may need surgery or extensive rehabilitation to recover from this injury. […] Exercises you can do at home can help you while you wait for surgery or work on your rehabilitation. Start with the safest exercises and avoid compressing or putting weight on your injured knee. […] After the swelling subsides, you can try exercises that are done while standing on both legs.

• #40 ACL Rehabilitation Phase 1 | MOON Knee ACL Research

  https://acltear.info/anterior-cruciate-ligament-rehabilitation/acl-rehabilitation-phase-1/

  Hamstring and quadriceps co-contraction will help activate (tense and then relax) both these muscles together. This is important for walking, taking stairs, standing up and sitting down. […] Straight leg raises (SLR) let you continue to develop quadricep strength and function for return to walking and daily activities. […] Heel raises improve calf strength. This will help you walk and, later in your rehabilitation, jump and run. […] Patellar mobilization helps you more easily bend and straighten your knee. It also helps reduce knee tightness symptoms.

• #41 ACL injury – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acl-injury/diagnosis-treatment/drc-20350744

  Your doctor may recommend surgery if: You’re an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting. More than one ligament or the fibrous cartilage in your knee also is injured. The injury is causing your knee to buckle during everyday activities. During ACL reconstruction, the surgeon removes the damaged ligament and replaces it with a segment of tendon tissue similar to a ligament that connects muscle to bone. This replacement tissue is called a graft. After surgery you’ll resume another course of rehabilitative therapy. Successful ACL reconstruction paired with rigorous rehabilitation can usually restore stability and function to your knee. There’s no set time frame for athletes to return to play. Recent research indicates that up to one-third of athletes sustain another tear in the same or opposite knee within two years. A longer recovery period may reduce the risk of re-injury. In general, it takes as long as a year or more before athletes can safely return to play. Doctors and physical therapists will perform tests to gauge your knee’s stability, strength, function and readiness to return to sports activities at various intervals during your rehabilitation. It’s important to ensure that strength, stability and movement patterns are optimized before you return to an activity with a risk of ACL injury.

• #42 Everything you need to know about ACL injuries and treatment – Dr Peter Hardcastle

  https://orthopaedichealth.co.za/everything-you-need-to-know-about-acl-injuries-and-treatment/

  To achieve this, patients will need to rest the knee for a few weeks before surgery and pre-operative physiotherapy is vital. […] Patients who cannot stand or weight bear on the affected leg or have a very swollen or painful knee will have to use crutches until their surgery. […] During arthroscopic ACL reconstruction surgery, I remove the torn ACL and replace it with a graft. […] Most ACL reconstructions are done as day cases, which means that the patient will arrive early in the morning and leave in the afternoon. […] After the operation, patients will experience discomfort which will be managed with medication and icing. […] If you do your rehab properly, your knee should be as good as the other knee. […] Most patients with an ACL injury will need to avoid playing sport for nine months to a year, depending on their individual case.

• #43 Anterior cruciate ligament injury – Wikipedia

  https://en.wikipedia.org/wiki/Anterior_cruciate_ligament_injury

  Delaying return to sport is recommended for at least a minimum of nine months, as retear rates become 7x more likely for those returning prior to 9 months. […] Patients need to ensure their physical therapist is experienced with treating ACL patients as many therapists can set their patients up for failure. […] There are numerous guidelines regarding ACL rehabilitation recommendations and interventions. […] In 2022, a systematic review was conducted on ACL rehabilitation that refutes the usefulness of post-operative bracing. […] Neuromuscular electrical stimulation (NMES) is strongly recommended in the earliest phase after surgery. […] A program of five phases of rehab was created to recover and return to sport post ACLR. […] Psychological readiness is a crucial factor in determining when an athlete can safely return to sport following ACL reconstruction.

• #44 Guide | Physical Therapy Guide to Anterior Cruciate Ligament Tear | Choose PT

  https://www.choosept.com/guide/physical-therapy-guide-anterior-cruciate-ligament-tear

  If your orthopedic surgeon determines that surgery is necessary, your physical therapist can work with you before and after your surgery. […] Your orthopedic surgeon will provide postsurgery instructions to your physical therapist, who will design an individualized treatment program based on your specific needs and goals. […] Your physical therapist will help you decrease your swelling, increase the range of movement of your knee, and strengthen your thigh muscles (quadriceps). […] Your physical therapist may use electrical stimulation to help restore your thigh muscle strength, and help you achieve those last few degrees of knee motion. […] Physical therapists design return-to-sport treatment programs to fit individual needs and goals. […] Preventive physical therapy programs have proven to lower ACL injury rates by 41% for female soccer players. […] You may want to consider a physical therapist who is experienced in treating people with orthopedic (musculoskeletal) problems.

• #45 Timeline of ACL Recovery: How Long Does an ACL Tear Take to Heal?

  https://www.healthline.com/health/how-long-does-an-acl-tear-take-to-heal

  Generally, it takes at least 9 months to recover after ACL reconstruction surgery. […] Physical therapy is crucial especially at this stage to prevent scar tissue formation and reduce inflammation. […] Its important to work closely with your physical therapist and avoid reintroducing sports or activity too soon as this can increase your risk of reinjury. […] Reinjury occurs in around 1 in 5 athletes that received ACL reconstruction surgery. […] It can be prevented by strictly following your rehabilitation protocol, not returning before youre ready, and receiving clearance from your surgeon and PT before resuming activities. […] If you wish to return to your sport, its important that you follow a strict rehabilitation program designed by a physical therapist and wait until you receive clearance, which takes an average of nine months of recovery time.

• #46 Anterior Cruciate Ligament Injury Treatment & Management: Acute Phase, Recovery Phase, Maintenance Phase

  https://emedicine.medscape.com/article/89442-treatment

  Hamstring tendon (HT) grafts are associated with a faster recovery and less anterior knee pain. […] Nonoperative treatment may be considered in elderly patients or in less active athletes who may not be participating in any pivoting type of sports (eg, running, cycling). […] Postoperative treatment is discussed. […] Return to all sports without activity may take 6-9 months and should be closely monitored by the surgeon and physical therapist. […] The use of knee braces remains a highly controversial topic; braces are well accepted by patients, but most biomechanical studies do not support their use. […] Once quadriceps strength reaches 65% of the opposite leg, sports-specific activities may be performed; this usually occurs within 5-8 weeks postsurgery. […] According to a study by Grindem et al, returning to level I sports after ACL reconstruction leads to a more than 4-fold increase in reinjury rates over 2 years. […] A study by Paterno et al showed that when a 90% threshold is used, current criteria for return to sport fail to determine whether adolescent and young adult athletes are at high risk for a second ACL injury following ACL reconstruction.

• #47 Treatment After Anterior Cruciate Ligament Injury: Panther Symposium ACL Treatment Consensus Group

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7315684/

  However, with persistent functional instability, or when episodes of giving way occur, anatomic ACL reconstruction is indicated. […] Successful outcomes after both operative and nonoperative treatments necessitate progressive rehabilitation, which entails staged and phase-adjusted physical therapy with the aim to address impairments, achieve functional stability, and safely return to sport. […] Any discussion of nonoperative treatment within this consensus document implies the completion of a progressive, staged rehabilitation protocol. […] Similarly, any discussion of operative treatment implies anatomic ACL reconstruction. […] Comprehensive rehabilitation after operative ACL reconstruction is also paramount for clinical outcome and return to sport. […] There is still uncertainty as to which patients should undergo immediate surgery and which patients may be successfully treated nonoperatively.

• #48 ACL Injury: Does It Require Surgery? – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/treatment/acl-injury-does-it-require-surgery/

  ACL Injury: Does It Require Surgery? […] The following article provides in-depth information about treatment for anterior cruciate ligament injuries. […] The information that follows includes treatment options for ACL injuries along with a description of ACL surgical techniques and rehabilitation, potential complications, and outcomes. […] What happens naturally with an ACL injury without surgery varies from patient to patient and depends on the patient’s activity level, degree of injury, and instability symptoms. […] Progressive physical therapy and rehabilitation can restore the knee to a condition close to its pre-injury state and teach the patient how to prevent instability. […] Surgical treatment is usually recommended for combined injuries (ACL tears that occur along with other injuries in the knee).

• #49 Patient education: Anterior cruciate ligament injury (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/anterior-cruciate-ligament-injury-beyond-the-basics

  Are willing to complete the rigorous post-surgical rehabilitation program. Most programs require daily strengthening and stretching exercises and one or more weekly visits with a physical therapist for the first three to six months after surgery. Failure to follow this program could increase the risk of re-injury, allow scar tissue to develop, and lead to limited movement of the knee. […] You may decide not to have surgery if you: […] Have a small partial tear in the ACL that may heal with rest and rehabilitation […] Do not participate in sports that require pivoting or stopping quickly, especially if you are older than 55 years […] Are willing to complete a non-surgical rehabilitation program to strengthen and stabilize the knee. […] If you do not have surgery to reconstruct your ACL, you may be at an increased risk of future knee problems, including chronic pain, a decreased level of activity, and injury to other parts of the knee (the meniscus). However, surgery is also not a „quick fix,” as it involves a challenging recovery period and requires committing to a rigorous rehabilitation program.

• #50 ACL Treatment Options | OrthoVirginiaSearch

  https://www.orthovirginia.com/blog/acl-treatment-options/

  The ACL is the anterior cruciate ligament, which runs between the femur (thigh bone) and tibia (shin bone) at the knee. Its main job is to provide stability to the knee. The typical ACL injury is caused by the knee hyperextending, which means the knee is stretched too far or is extended past the normal range of motion. The ACL does not tend to heal very well or very reliably, so treatment is needed. […] Non-surgical treatment tends to be best for people who might be older or less active or who already have some arthritis. However, most people get better results with surgery. […] Historically, many knees have been stiff if surgery is performed soon after an ACL tear. Traditionally surgeons would wait at least six weeks before operating, but some newer research suggests that patients do better with earlier surgery, even as soon as less than 48 hours after injury. The most important thing before surgery is for the knee to have some range of motion and strong supporting muscles. This requirement means that every ACL case is different and every surgery ends up being on its own timeline.

• #51 ACL Tear, ACL Repair, ACL Reconstruction Surgery | EmergeOrtho

  https://emergeortho.com/conditions/acl-injuries/

  The anterior cruciate ligament (ACL) is one of four ligaments in the knee joint that holds the bones together and provides stability. […] EmergeOrthos board-certified, fellowship-trained physicians are leading experts in the diagnosis, treatment, and rehabilitation of ACL injuries. […] A tailor-made treatment plan will be developed based on your injury and physical demands. […] EmergeOrtho always considers conservative, nonsurgical treatments before proposing surgical intervention. Sometimes, minor ACL injuries can be successfully treated with immobilization in a brace and/or a physical therapy program. […] More severe cases, however, will require ACL arthroscopic reconstruction surgery. […] In order to increase the chances of a successful recovery, rehabilitation instructions provided by your doctor should be followed carefully and accurately. […] No matter your needs, EmergeOrtho is dedicated to providing you with optimal care that will help you return to the activities you love and Emerge Stronger. Healthier. Better.

• #52 ACL Tear and Physical Therapy: A Guide | The Jackson Clinics

  https://thejacksonclinics.com/acl-tear-physical-therapy/

  An ACL tear, a common injury among athletes, can quickly put your mobility and sporting activities on hold. […] If you’ve experienced an ACL tear, you might be wondering what steps to take next. […] Accurate diagnosis of an ACL tear is crucial for effective treatment. […] Once an ACL tear is confirmed, a comprehensive plan of ACL injury recovery is developed. […] The Jackson Clinics physical therapists are skilled in both identifying these symptoms and implementing effective exercises for ACL injuries to aid in your recovery. […] Physical therapy for ACL tear is a critical part of the recovery process, focusing on promoting healing and restoring full knee function. […] Early intervention using ACL tear rehab exercises can speed up recovery times, minimize pain, and prevent muscle atrophy.

• #53 ACL tear treatment | Ohio State Health & Discovery

  https://health.osu.edu/health/bone-and-joint/acl-tear-treatment

  Several studies show that it typically takes two years for the bone and graft in a reconstructed knee to be 100% recovered. […] However, athletes who are committed to rehabilitation can typically get back to playing in around nine months, Dr. Kaeding says. […] Over the past 30 years, treatment plans, outcomes and perception around ACL reconstruction have changed drastically. […] Reports show that over 90% of athletes experience a successful restoration of stability and return to full usage of their knee after ACL reconstruction surgery. […] However, present-day ACL reconstruction and rehabilitation techniques are allowing individuals to return to daily life more quickly and safely than previously thought possible, as well as sustaining the careers of athletes. What used to be a 12-month minimum recovery for an athletes return to sport is now five to six months in some cases. […] Advancements in neuromuscular training also offer preventive measures to improve the strength of athletes knees. Prevention training is a modern development with growing popularity, due to its demonstrated effectiveness in reducing the chance of an ACL injury.

• #54

  https://www.nbcnews.com/health/health-news/knee-injury-acl-treatment-heal-surgery-rcna99606

  Recent research suggests that a nonsurgical treatment, including physical therapy, could be as effective, sparking controversy among surgeons who perform dozens of ACL reconstructions every year. […] Patients underwent physical therapy as their braces were slowly adjusted to increase the range of motion. […] This study could be a game changer, said Dr. Lyle Micheli, an orthopedic surgeon at Boston Childrens Hospital and a professor at Harvard Medical School, who was not involved in the new research. […] The research also suggests that nonoperative treatment could be a viable option for people who dont play professional or competitive sports or cant get surgery because of financial or health complications, he said. […] ACL surgery has a big role in managing ACL tears, but too often the nonoperative treatment is ignored, said Sallis, who is also chief medical officer for the Major League Soccer team Los Angeles FC.

• #55 ACL injury – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acl-injury/symptoms-causes/syc-20350738

  Depending on the severity of your ACL injury, treatment may include rest and rehabilitation exercises to help you regain strength and stability, or surgery to replace the torn ligament followed by rehabilitation. […] Proper training and exercise can help reduce the risk of ACL injury. […] Programs to reduce ACL injury include: […] Training to strengthen muscles of the legs, hips and core as well as training to improve jumping and landing techniques and to prevent inward movement of the knee may help to reduce the higher ACL injury risk in female athletes. […] Wearing a knee brace doesn’t appear to prevent ACL injury or reduce the risk of recurring injury after surgery.

• #56 Anterior Cruciate Ligament Knee Injury – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499848/

  Return to play: this is a controversial area with no definite criteria on return to sports, either timing or type of sports involved. Previously, there was an agreement that return should not be earlier than nine months postoperatively. However, patients should be able to demonstrate the ability to perform certain sport-specific activities and complete a series of functional tests such as various single- and double-leg hopping and jumping. […] For injury prevention, certain factors can be employed with particular reference to female athletes who might benefit from neuromuscular training, plyometrics (jump training), training to land from jumping in less valgus and more knee flexion, in addition to increasing hamstring strength to decrease quadriceps dominance ratio.

• #57 Anterior Cruciate Ligament (ACL) Tears (for Teens) | Nemours KidsHealth

  https://kidshealth.org/en/teens/acl-injuries.html

  Physical therapy is important to help the knee heal. PT helps to: improve range of motion and flexibility, regain strength in the knee, thigh, and shin muscles, reduce pain and swelling, improve balance. […] Training programs may help you avoid another ACL tear. These focus on neuromuscular training (NMT). NMT teaches movement patterns that lower the risk of injury, especially while jumping, landing, and changing direction. NMT programs include stretching, plyometrics (jump training), and balance training.

• #58

  https://www.hingehealth.com/resources/articles/acl-injury/

  While some ACL tears may require immediate surgery, the recommended approach is to start with prehab exercise therapy before surgery to determine if function and stability can be regained without it. […] The goal is to get you back to doing the activities you enjoy, and sometimes that requires surgery. Dont think your prehab was for nothing whether you have surgery or not, physical therapy is a pivotal part of recovery. All the strengthening you did before surgery will aid in your post-op recovery as you return to PT to continue to regain strength and function. […] All these exercises can help keep your knees healthy whether youre looking to prevent an ACL injury or avoid a reinjury. They can also help to minimize the effects of other knee problems, like arthritis, in the future.

• #59 Treatment After Anterior Cruciate Ligament Injury: Panther Symposium ACL Treatment Consensus Group

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7315684/

  However, with persistent functional instability, or when episodes of giving way occur, anatomic ACL reconstruction is indicated. […] Successful outcomes after both operative and nonoperative treatments necessitate progressive rehabilitation, which entails staged and phase-adjusted physical therapy with the aim to address impairments, achieve functional stability, and safely return to sport. […] Any discussion of nonoperative treatment within this consensus document implies the completion of a progressive, staged rehabilitation protocol. […] Similarly, any discussion of operative treatment implies anatomic ACL reconstruction. […] Comprehensive rehabilitation after operative ACL reconstruction is also paramount for clinical outcome and return to sport. […] There is still uncertainty as to which patients should undergo immediate surgery and which patients may be successfully treated nonoperatively.

• #60 What happens during physical therapy for an ACL injury?

  https://www.riversideonline.com/en/patients-and-visitors/healthy-you-blog/blog/w/what-happens-during-physical-therapy-for-an-acl-injury

  If youre still in pain or your knee sometimes feels unstable after several weeks of physical therapy, or you choose to have surgery right away, physical therapy will begin the day after surgery. […] The first goal is to return to a full range of motion while also getting the swelling and pain under control. […] In the beginning, physical therapists focus on strengthening the quad (thigh) muscles, which become very weak after surgery. Therapy will also include stretches and working to regain the ability to walk and go up and down stairs without an assistive device like crutches. […] After ACL surgery, athletes need at least six months before returning to sports. While it depends on the patient, we try and keep athletes in physical therapy for six to nine months, says Moore. But for people who just want to go to work and play with their kids, and they’re not interested in doing anything too strenuous, heir rehabilitation may be completed in about four or five months.

• #61 Anterior cruciate ligament injury – Wikipedia

  https://en.wikipedia.org/wiki/Anterior_cruciate_ligament_injury

  ACL reconstruction surgery involves replacing the torn ACL with a „graft,” which is a tendon taken from another source. […] The surgery is done with an arthroscope or tiny camera inserted inside the knee, with additional small incisions made around the knee to insert surgical instruments. […] Young athletes or anyone opting for ACL surgery should consider delaying their surgery and completing a 4-6 week prehabilitation program. […] The American Academy of Orthopedic Surgeons has stated that there is moderate evidence to support the guideline that ACL reconstruction should occur within five months of injury in order to improve a person’s function and protect the knee from further injury. […] The goals of rehabilitation following an ACL injury are to regain knee strength and motion. […] If an individual with an ACL injury undergoes surgery, the rehabilitation process will first focus on slowly increasing the range of motion of the joint, then on strengthening the surrounding muscles to protect the new ligament and stabilize the knee.

• #62 Guide | Physical Therapy Guide to Anterior Cruciate Ligament Tear | Choose PT

  https://www.choosept.com/guide/physical-therapy-guide-anterior-cruciate-ligament-tear

  If your orthopedic surgeon determines that surgery is necessary, your physical therapist can work with you before and after your surgery. […] Your orthopedic surgeon will provide postsurgery instructions to your physical therapist, who will design an individualized treatment program based on your specific needs and goals. […] Your physical therapist will help you decrease your swelling, increase the range of movement of your knee, and strengthen your thigh muscles (quadriceps). […] Your physical therapist may use electrical stimulation to help restore your thigh muscle strength, and help you achieve those last few degrees of knee motion. […] Physical therapists design return-to-sport treatment programs to fit individual needs and goals. […] Preventive physical therapy programs have proven to lower ACL injury rates by 41% for female soccer players. […] You may want to consider a physical therapist who is experienced in treating people with orthopedic (musculoskeletal) problems.

• #63 ACL Surgery > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/acl-surgery

  ACL reconstruction is typically an outpatient procedure. […] The procedure is arthroscopic, which means it involves several small incisions and the insertion of a tiny camera and instruments to allow the surgeon to see inside the knee joint and to perform the operation. […] Following instructions for physical therapy and rehabilitation is imperative. […] The decision of when to return to sports and unrestricted activities requires collaboration between the patient, the surgeon, and the physical therapist. […] The success rate for ACL surgery done correctly and with proper rehabilitation is very high.

• #64 ACL Tear Repair | Torn ACL | Duke Health

  https://www.dukehealth.org/treatments/orthopaedics/torn-acl

  Bridge-enhanced ACL repair (BEAR) is a new FDA-approved procedure that allows a torn ACL to heal itself and does not require graft tissue to be taken from another part of the body. […] You will start knee-specific physical therapy immediately. Physical „prehab” prepares your knee for ACL surgery and ensures you have a faster recovery. […] After surgery, your physical therapists work on strength and conditioning of your knee. Functional movement screening, developed at Duke, gives your doctor objective measurements of your recovery and helps them determine when you can safely return to your normal activities. This minimizes the risk of re-injury. […] Duke knee specialists include primary care sports medicine specialists, orthopaedic physician assistants, ACL surgeons, and physical therapists who specialize in knee injuries associated with specific sports.

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