'Pop' goes the knee

Every doctor will tell you that there are many benefits to exercising and maintaining an active lifestyle. The flipside of the coin, however is that exercise is not always good for your knees. The anterior cruciate ligament (ACL) is particularly vulnerable in certain sports, such as volleyball, gymnastics, basketball, soccer and football.

The ACL is one of the ligaments which controls the rotation, stability, as well as backward and forward motion of the knee. Most ACL injuries happen during sports and fitness activities. The ligament may tear when you slow down suddenly to change direction, or pivot with your foot firmly planted, or by twisting or overextending your knee.

Dr Tan Jee Lim, orthopaedic surgeon from Gleneagles Hospital, shares his expertise with us.

Symptoms of Anterior Cruciate Ligament Tear
When the ACL tears, the individual can hear or feel a 'pop' in the knee, and the pain can be excruciating. This is followed by swelling in the knee in about two to three hours. They will have difficulty putting his weight on the knee, and have to hobble to get around for a few days. When the swelling subsides and they feel better, that's where people are mistaken that it has recovered - only to have their knee giving way when they next put their weight on it.

If you should experience any signs of ACL injury, do not delay in seeking treatment. The longer you wait the long it will take to recover.

Anterior Cruciate Ligament Injury Treatment
Treatment for ACL injury depends on the lifestyle, overall condition and age of the patient. Elderly or sedentary people who are not into sports would be advised non-surgical medication to bring down the swelling, followed by physiotherapy.

For those who are more active, surgical treatment may be required to replace the ACL to prevent further damage to the cartilage in the knees. After ACL reconstruction, patients need to undergo rehabilitation for at least six months, supported by physiotherapy to ensure good recovery.

According to Dr Tan, about 30% of ACL injuries develop osteoarthritis about 10 years later if left untreated. In addition, 70% of ACL injuries are associated with meniscal injuries. Meniscus is shock absorber for the knee joint. When they are lost, stress on the cartilage increases by 300 times, leading to high risk of osteoarthritis.

Case Study: The Vietnamese Soccer Star
Mai Tien Thahn is a 24-year old soccer star. A household name in Vietnam, he was the top scorer in the Southeast Asian Games of 2009. But during a soccer game, he injured his knee when he stopped abruptly. The sudden jerk tore the ACL in his right knee.

Raring to return to the pitch, he underwent keyhole surgery to reconstruct his ACL. Dr Tan removed two hamstrings from Mai Tien's right knee, and secured it to the shin and thigh bone with medical screws. The entire procedure took one hour and was a good success. Full recovery is expected within six to nine months after the surgery. There is a chance he is playing on a TV screen near you by the time you read this article!

Publication of article by courtesy of Dr Tan Jee Lim, Orthopaedic Surgeon from Gleneagles Hospital.