Anterior Cruciate Ligament Injury: Injuries That Are 4 Times More Common in Women
How arthroscopy can help with permanent recovery
Hello, I'm Ricardo Monge, I'd like to address one of the most common injuries in women and how it's treated as a trauma specialist in anterior cruciate ligament reconstruction through arthroscopy.
The knee is a joint with many structures that need to work in harmony to stay balanced and function efficiently. The muscles, ligaments and tendons work synchronously so that in every range of motion you give it, it remains balanced and in place.
The anterior cruciate ligament is located in the center of the knee, connecting the tibia bone to the femur. It's one of the main stabilizers of the knee, responsible for preventing displacement of the tibia under the femur. When it ruptures or overstretches, there's an imbalance in these structures that can cause discomfort such as loss of range of motion, swelling and pain due to overloading of the knee parts.
You may wonder: How exactly can it get injured? This happens when the knee twists or hyperextends or receives a direct blow. This will cause a popping sound followed by instability or...
Why are women more prone to ACL injuries?
The higher incidence of anterior cruciate ligament injuries in women is attributed to anatomical, hormonal and biomechanical factors.
Anatomical factors:
The anterior cruciate ligaments in women are thinner compared to men's, the wider pelvis, shorter femur, and the angles formed between the patellar tendon and the tibia make them more prone to injury due to the increased angle that generates more stress on the ACL compared to men.
Hormonal factors
During the follicular and luteal phases of the menstrual cycle, when estrogen and progesterone levels are highest, changes occur in the proliferation and synthesis of fibroblasts that function to secrete collagen, which helps maintain the structural framework of tissues. This causes ligament laxity and therefore an injury risk during these phases.
Biomechanical factors
During certain movements, female athletes tend to have greater internal rotation and hip adduction which causes greater knee valgus and therefore greater load on the anterior cruciate ligament. Landing also influences because many athletes tend to land with less knee flexion and greater quadriceps participation, which generates more tension on the ligament.
Why is arthroscopy the best option for an ACL injury?
Arthroscopy is one of the least invasive interventions with a 95% success rate and is one of the most performed in the world with about 2 million patients per year. It's a procedure with a quick recovery time due to smaller incisions and a very low risk percentage since complications such as infections or clots are avoided.
If a damaged ACL is not treated, it can generate greater instability and stress on the knee with a high probability of meniscus rupture. Therefore, arthroscopy is a quick and efficient way to resolve an injury.
What happens during an anterior cruciate ligament arthroscopy?
During arthroscopy, through a small incision, a camera is inserted into the center of the knee where the ACL is located, which is transmitted via a screen that allows us to examine the ligaments and other tissues of the knee. The tissue, depending on its condition, may only require reconstruction if the damage is severe, it's replaced with your own tissue, usually tissue can be taken from a patellar tendon, a quadriceps tendon or a graft from a cadaver.
During this procedure, other incisions will be made around the knee and other instruments will be introduced to repair the ACL or replace it if necessary.
What to expect after an ACL arthroscopy?
The most advisable would be the use of crutches the first few days, avoid standing or walking for prolonged periods
- A diet rich in proteins, vitamins and minerals is recommended
- Apply cold compresses
- Maintain adequate compression to reduce swelling
- Keep the leg elevated
- Follow the medical prescription precisely
Perform the recommended instructions within the stipulated time until it's recommended to complement it with a physiotherapist to begin rehabilitation of range of motion and strength.
Remember to attend your follow-up visits and be very patient, everyone has a different recovery process, it's not always about speed but about the stability and health that the body requires.
Any questions or comments let me know, schedule your appointment so I can help you.