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Anterior cruciate ligament rupture and management

Department of Orthopaedics, Addenbrooke’s Hospital, Cambridge, UK., bowditch{at}bigfoot.com

Anterior cruciate ligament rupture is a common knee injury in young people. It is the commonest cause of an acute haemarthrosis following trauma. Acute management involves aspiration, the restoration of full movement, followed by muscle rehabilitation. The long-term natural history of non-operative management is usually a failure to return to high level sports and in most, symptomatic instability with secondary meniscal and chondral injury. The late outcome is that of premature degenerative arthritis. Reconstructive techniques are now advanced and minimally invasive. However, considerable technical skill and experience is required to avoid complications. Physiotherapy guided rehabilitation over 4-6 months is vital prior to a return to sport. The stabilised knee should reduce secondary injury and progressive degenerative disease. In the future an increased number of reconstructions, tissue engineered grafts and accelerated healing will probably be seen.

Key Words: knee • ligament • cruciate • anterior

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