Published on April 6th, 20180
St. Luke’s Dr. Reddy – the ACL Specialist
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.