Anterior Cruciate Ligament (ACL) Issues

ACL injuries occur most frequently during sports activities. Approximately 70% of individuals with ACL injuries report twisting their knee during the injury. Swelling of the knee typically occurs within the first 24-48 hours after the injury. In the long term, the most common problem experienced is a feeling of instability in the knee. ACL injuries may occur alone or in combination with meniscus, cartilage, or other ligament injuries. Therefore, it is important to perform a thorough physical examination along with the necessary radiological tests.

Non-Surgical Treatment:

Partial tears or low-energy skiing injuries are suitable candidates for non-surgical treatment. Non-surgical treatment typically includes strengthening the muscles around the knee and proprioceptive (position sense) exercises. Rehabilitation training programs, high-intensity laser therapy (hiltherapy), and matrix rhythm therapy may also be used. Additionally, adjusting the type of sports activities, such as avoiding contact sports, can be beneficial.

Surgical Treatment:

Athletes involved in sports such as football, basketball, handball, and tennis generally cannot return to their sport without surgery. For amateur athletes participating in these sports, surgery is recommended to prevent additional injuries (to the cartilage or meniscus).

Additionally, individuals who perform intense physical activities due to their occupation (such as soldiers, police officers, and firefighters) should undergo ACL reconstruction. However, not all athletes require ACL reconstruction.

For example, individuals with ACL tears who engage in recreational skiing without participating in competitive events may continue skiing without surgery.

Moreover, older individuals or those not involved in sports may continue their daily lives without ACL reconstruction. These individuals should only undergo surgery if they experience a feeling of instability in their knee.

Surgical Options:

In surgical treatment, grafts can be taken from the patient’s own body (autograft) or from a cadaver (allograft).

Before surgery, it is crucial to ensure the knee has full range of motion and that the surrounding muscles are strong, as this improves the chances of a successful outcome.

The return to sport typically ranges from 6 to 12 months, depending on the patient’s progress in physical therapy.

Posterior Cruciate Ligament (PCL) Issues

The posterior cruciate ligament is thicker than the anterior cruciate ligament, and when injured on its own, it causes instability less frequently compared to ACL injuries. Therefore, PCL injuries may be overlooked and lead to slow, insidious progression of osteoarthritis (joint degeneration).

PCL injuries may occur alone or in combination with other ligament injuries. Conditions where three or more ligaments are injured are classified as knee dislocations. PCL injuries (especially those combined with multiple ligament injuries) lead to a feeling of instability, pain, and can cause osteoarthritis in the long term.

PCL injuries may involve partial tears, complete tears, or multi-ligament injuries.

Non-Surgical Treatment:

Non-surgical treatment is applied in cases of isolated PCL injuries or when multi-ligament injuries are too complex for surgery. The treatment includes strengthening the muscles around the knee and proprioceptive (position sense) exercises. In addition, rehabilitation programs, high-intensity laser therapy (hiltherapy), and matrix rhythm therapy may be helpful. Adjusting physical activities (e.g., avoiding contact sports) is also recommended.

Surgical Treatment:

Surgical techniques and graft options are similar to those used for ACL injuries.