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It has associated its name with high-performance athletes, as a result of falling from a height, abrupt change of direction, or immediate injury of the knee, but it can also apply to anyone involved in sports, even at an amateur level, although it is possible that ACL injuries are still an accident’s result. Rupture of the anterior cruciate ligament, one of the most serious and common injuries to the knee, results in a long recovery period. The ACL, along with the posterior cruciate ligament, the medial and the lateral collateral ligament, are all knee stabilizers. ACL’s main role is to prevent the tibia from slipping forward in relation to the thigh - in fact it provides 90% stability in one knee. It crosses the joint diagonally and connects the back of the femur to the top of the tibia.
Most people who have had a ruptured ACL describe hearing a "pop" or "crack", and then having their leg swollen. Deep pain in the knee and swelling are the first signs, while depending on the injury, the movement of the knee joint is limited and there is instability. The diagnosis is made mainly with the guidance of the clinical picture, which will show how stable and functional the knee is. Very important role in the detection of other knee lesions (meniscus rupture, cartilage lesions, etc.) plays the MRI. The evolution of MRI, and therefore the better imaging of knee pathology, has resulted in recent years in proving that anterior cruciate ligament rupture need not to be complete. In cases of partial rupture, an accurate history and a thorough examination will demonstrate the correct treatment, and the necessity or not of a surgery.
In cases of complete ACL rupture, taking into account the age, sex, occupation and sport of the patient (and given that the anterior cruciate ligament does not heal and its function is not restored), surgery is usually one-way. The doctor will use an autograft (a graft from the same patient) to replace the ligament so that the knee becomes stable and functional again.
Modern arthroscopic surgery refers to a personalized approach in the case of ACL rupture. The specialized, modern surgeon is called to decide if the patient needs to be operated and if so, he must decide which implant he will use in order to restore properly the knee function. At the Athens Orthopedic Center MINISCOTM we personalize this option, depending on the age, activities, somatometric measurements, anatomical features from the MRI, the elasticity of the joints, the position played by the athlete (eg goalkeeper or center back, etc.). The individualized approach to the ACL rupture is something that makes perfect sense, since it is not possible for an implant to "fit" all patients. It is common practice for the orthopedic surgeon to apply the same implant to all patients (what he knows, which according to studies has usually been the hamstrings’ autograft). We, on the other hand, at the Athens Orthopedic Center MINISCO apply the individualized approach to the restoring of this serious injury of the ACL, in order for each patient to "wear" the implant that suits him best, in order to reconstruct his injury and to have less possibility of reinjury. The most common areas of harvesting of the autograft are: Depending on the implant we choose for each patient, we proceed to customized postoperative rehabilitation protocols, always in collaboration with the physiotherapists and rehabilitation gymnasts we work with, always aiming at the safe and quick return of the patient to his daily life and sports activities!
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