ACL injuries – tears of the anterior cruciate ligament that helps stabilize the knee – occur far too often in athletes.
The National Institutes of Health projects up to 200,000 per year in the United State alone, most commonly in sports that involve quick changes of direction like football, soccer, basketball and downhill skiing.
“Females are more prone to ACL tears because their inter-condylar, the area on the distal femur where the ACL, posterior cruciate ligaments attach, is typically narrower than a male’s,” says Chandra Reddy, MD, an orthopedic surgeon with St. Luke’s Orthopedic Care.
The ACL prevents the knee from hyperextending, an action that placed the three other knee ligaments at risk. It also prevents the supporting shinbone – the tibia – from moving ahead of the femur.
Dr. Reddy says the incidence of ACL tears in younger athletes is increasing, most likely due to the recent practice of children playing more intense sport year-round instead of a variety of sports throughout the various seasons, and not giving the body much needed rest and recuperation time.
When an athlete tears an ACL, surgery is generally recommended, although a small percentage of people can function almost normally if there are no signs of instability and the person lives a relatively sedentary lifestyle. Surgery is not normally recommended for younger children.
“In very young children, for example those whose growth plates are still open, ACL reconstruction becomes more technically challenging,” says Dr. Reddy.
“You cannot use regular adult techniques and drill holes across the growth plates because it may cause growth arrest.
“Instead, we use a C-arm X-ray, which provides high-resolution X-rays, to avoid crossing the growth plate during surgery,” he says.
This helps Dr. Reddy perform an “all inside” technique through keyhole surgery -- minimally invasive arthroscopy -- without having to make any large incisions.
Athletes can do specific exercises to decrease the chance of tearing an ACL or other knee ligament. Plyometric exercise – jumping maximum force in a minimum amount of time and stretching seem to help, according to Dr. Reddy, but the jury is still out on wearing prophylactic knee braces like you see on many college and professional football offensive linemen.
About St. Luke’s
Founded in 1872, St. Luke’s University Health Network (SLUHN) is a fully integrated, regional, non-profit network of 14,000 employees providing services at 10 hospitals and over 300 outpatient sites. With annual net revenue of $1.9 billion, the Network’s service area includes 10 counties: Lehigh, Northampton, Berks, Bucks, Carbon, Montgomery, Monroe and Schuylkill counties in Pennsylvania and Warren and Hunterdon counties in New Jersey. Dedicated to advancing medical education, St. Luke’s is the preeminent teaching hospital in central-eastern Pennsylvania. In partnership with Temple University, St. Luke’s created the region’s first and only regional medical school campus. It also operates the nation’s longest continuously operating School of Nursing, established in 1884, and 28 fully accredited graduate medical educational programs with 226 residents and fellows. St. Luke’s is the only health care system in central-eastern Pennsylvania to earn Medicare’s five-star rating (the highest) for quality, efficiency and patient satisfaction. St. Luke’s has earned the 100 Top Major Teaching Hospital designation from IBM Watson Health (formerly Truven Health Analytics) repeatedly – six times total and four years in a row including 2018. It has also been cited by IBM Watson Health as a 50 Top Cardiovascular Program. Utilizing the EPIC electronic medical record (EMR) system for both inpatient and outpatient services, the Network is a multi-year recipient of the Most Wired award recognizing the breadth of the SLUHN’s information technology applications such as telehealth, online scheduling and online pricing information. St. Luke’s is also recognized as one of the state’s lowest cost providers.