ACL Injuries in Athletes and Surgical Treatment
The anterior cruciate ligament (ACL) is one of the most important stabilizers of the knee joint. ACL injuries are frequently seen in sports, especially in football, basketball, skiing, and volleyball, where sudden stops and directional changes are common. Such injuries cause knee instability, negatively impacting athletic performance and, if left untreated, may lead to degenerative issues like osteoarthritis in the long term.
The primary cause of ACL injury is excessive strain on the knee due to sudden changes in direction, stopping, or forceful movements. Direct trauma and twisting of the knee in a bent position also trigger these injuries. It is known that female athletes have a higher rate of ACL injuries because of hormonal and anatomical differences.
Symptoms of injury include sudden knee pain, swelling, limited range of motion, and a feeling of locking in the knee. A distinctive "pop" sound followed by rapid swelling is a crucial clinical sign for diagnosis. Physical examination tests, such as the Lachman test and Pivot shift test, are valuable diagnostic tools. Magnetic resonance imaging (MRI) is preferred for definitive diagnosis, clearly revealing the extent of ligament tears and any associated meniscus or cartilage damage.
Conservative treatment options for ACL injuries are limited, and reconstruction surgery is generally recommended. The surgical procedure involves replacing the damaged ligament with an autologous tendon graft, commonly the patellar tendon or hamstring tendons, to restore knee stability. This operation is performed arthroscopically, ensuring minimal invasiveness and quicker recovery.
Postoperative rehabilitation plays a critical role in the success of the treatment. Early phases focus on restoring knee mobility and strengthening muscles. The physiotherapy program is tailored according to the patient's condition and the surgical technique used. Decisions regarding return to sport consider knee stability, muscle control, and results from functional testing. Typically, athletes can resume sports between 6 to 9 months post-surgery, although full recovery and performance may vary individually.
ACL injuries continue to be a significant concern for athlete health. Preventative exercise programs focusing on muscle strengthening and proprioceptive training effectively reduce injury risk. Proper technical training and appropriate warm-up and cool-down routines are also essential for athletes.
Recent advances in surgical techniques have improved graft fixation, positioning, and biological healing support during reconstruction. Additionally, ongoing scientific research on graft options and postoperative recovery rates continuously enhances treatment approaches.
In summary, ACL injuries in athletes represent a serious orthopedic problem requiring a multidisciplinary approach. Early diagnosis, selection of appropriate surgical techniques, and comprehensive rehabilitation enable successful return to sport. The expertise of Prof. Dr. Halil İbrahim Balcı in extremity reconstruction surgery and sports surgery provides valuable guidance in applying current and effective treatment methods for ACL injuries.