Dr-M-Shahadat-Hossain

A grade 3 ACL injury is a severe tear or complete rupture of the knee’s ACL. This type of injury typically occurs due to a sudden twisting or impact on the knee, resulting in significant instability and pain. Treatment for a grade 3 ACL injury typically involves surgery to reconstruct the ligament, followed by physical therapy to regain strength and range of motion in the knee. Recovery time can take several months.

Contents hide
1 Risk factor for ACL Injury Grade 3
2 Causes of ACL Injury grade 3
3 Prevention from ACL injury Grade 3
4 The treatment plan for ACL Injury Grade 3
5 Reference

Risk factor for ACL Injury Grade 3

Several risk factors[1][7] can increase the likelihood of a grade 3 ACL injury, including:

  1. Participation in high-impact sports: Athletes who participate in sports that involve cutting, pivoting, and sudden changes of direction, such as soccer, football, and basketball, are at a higher risk of ACL injury.
  2. Weak thigh muscles: Weak thigh muscles, particularly the quadriceps, and hamstrings, can increase the risk of ACL injury.
  3. Poor landing mechanics: Individuals who land from jumps or falls with poor mechanics, such as landing with the knee in a valgus position, are at a higher risk of ACL injury.
  4. Poor flexibility: Individuals with poor flexibility, particularly in the hip and ankle, are at a higher risk of ACL injury.
  5. Previous ACL injury: Individuals with a prior ACL injury are at a higher risk of re-injuring the ligament or injuring the other knee.
  6. Footwear: Wearing shoes that do not fit properly or have worn-out soles can increase the risk of ACL injury.
  7. Hormonal changes: Hormonal changes such as the menstrual cycle can affect muscle tone and ligament laxity, increasing the risk of ACL injury in females.

Not all of these risk factors are modifiable, but addressing the modifiable ones can help reduce the risk of ACL injuries.

Causes of ACL Injury grade 3

The most common causes of a grade 3 ACL injury include:

  1. Trauma: The most common cause[2][5] of a grade 3 ACL injury is direct trauma to the knee, such as a collision or a fall. This can cause the ligament to tear or rupture completely.
  2. Twisting or pivoting: Twisting or pivoting motions, such as those that occur during sports like soccer, football, or basketball, can put a significant amount of stress on the ACL, leading to a tear or rupture.
  3. Sudden deceleration: Sudden deceleration, such as stopping quickly while running, can also put a lot of stress on the ACL and cause it to tear or rupture.
  4. Overuse: Repetitive stress on the ACL, such as from overuse, can also lead to a tear or rupture. This is more common in athletes who participate in sports that involve a lot of jumping or pivoting.
  5. Lack of warm-up: Not warming up properly before participating in sports or physical activity can also increase the risk of ACL injury.
  6. Poor landing mechanics: Individuals who land from jumps or falls with poor mechanics, such as landing with the knee in a valgus position, are at a higher risk of ACL injury.

Not all ACL injuries are caused by one specific event; sometimes, it can be a combination of factors or multiple small tears that lead to a complete rupture over time.

Prevention from ACL injury Grade 3

There are several ways to prevent[3][4] a grade 3 ACL injury, including:

  1. Strengthening exercises: Strengthening the muscles around the knee, particularly the quadriceps, hamstrings, and hip muscles, can help reduce the risk of ACL injury.
  2. Flexibility exercises: Improving flexibility in the hip and ankle can help reduce the risk of ACL injury.
  3. Proper warm-up: Warming up properly before participating in sports or physical activity can help prepare the body for the demands of the movement and reduce the risk of injury.
  4. Proper landing mechanics: Learning and practicing proper landing mechanics when jumping or falling can help reduce the risk of ACL injury.
  5. Proper footwear: Wearing shoes that fit properly and have good traction can help reduce the risk of ACL injury.
  6. Sports-specific training: Athletes who participate in sports that involve a lot of cutting, pivoting, and sudden direction changes can benefit from sports-specific training that focuses on these movements.
  7. Refraining from playing when injured: If you feel pain or discomfort, stop playing and seek medical attention. Continuing to play with an injury can worsen and increase the risk of further injury.
  8. Avoiding Hormonal fluctuations: Women at risk of ACL injury during their menstrual cycle can consult their doctor for preventive measures.

It’s worth noting that some of these preventions are more effective for certain types of people, such as athletes, and some may not apply to everyone. However, taking steps to address as many as possible can reduce the risk of ACL injury.

The treatment plan for ACL Injury Grade 3

A treatment plan for a grade 3 ACL injury typically includes the following steps:

Surgery: Surgery is typically the first step in treating a grade 3 ACL injury. The goal of surgery is to reconstruct the torn ligament. The most common surgical procedure used to reconstruct the ACL is called an ACL reconstruction, which involves replacing the torn ligament with a graft, typically taken from the patient’s tissue (autograft) or a donor (allograft).

Physical Therapy: After surgery, physical therapy is important to regain strength and range of motion in the knee. Physical therapy will typically focus on exercises to strengthen the quadriceps, hamstrings, and calf muscles, as well as exercises to improve flexibility in the knee and ankle.

Rehabilitation: The rehabilitation process will be tailored to each individual’s needs; it can take several months to recover fully. It typically involves progressive exercises to help regain strength, range of motion, and stability and improve the knee’s overall function.

Bracing: Depending on the type of surgery and the rehabilitation progress, the doctor may recommend using a knee brace. This can help protect the knee and provide added stability while the knee is healing.

Return to activity: It’s essential to wait until you fully recover before returning to any sport or physical activity. Returning too soon can increase the risk of re-injury. An individualized return to sport plan will be developed with the help of the physiotherapist and the surgeon.

It’s important to note that the recovery time can vary from person to person and can depend on many factors, such as age, health condition, and type of surgery. It’s important to follow the treatment plan the doctor and the physiotherapist provided.

A grade 3 ACL injury is a severe tear or complete rupture of the ACL. It occurs due to a sudden twisting or impact to the knee and results in significant instability and pain. The risk factors for ACL grade 3 injury include participation in high-impact sports, weak thigh muscles, poor landing mechanics, poor flexibility, previous ACL injury, footwear, and hormonal changes. Common causes of ACL grade 3 injury include trauma, twisting or pivoting, sudden deceleration, overuse, lack of warm-up, and poor landing mechanics. Treatment for a grade 3 ACL injury typically involves surgery to reconstruct the ligament, followed by physical therapy and rehabilitation to regain strength, range of motion, and stability and improve the knee’s overall function. It’s important to follow the treatment plan provided by the doctor and the physiotherapist and to wait until fully recovered before returning to any sport or physical activity. Some preventions can be done to reduce the risk of ACL injuries, such as strengthening and flexibility exercises, proper warm-up, proper landing mechanics, proper footwear, and sports-specific training.

Reference

1. Markolf KL, Mensch JS, Amstutz HC. Stiffness and laxity of the knee–the contributions of the supporting structures. A quantitative in vitro study. J Bone Joint Surg Am. 1976;58:583–594.

https://pubmed.ncbi.nlm.nih.gov/946969/

2. Griffin LY, Albohm MJ, Arendt EA, Bahr R, Beynnon BD, Demaio M, Dick RW, Engebretsen L, Garrett WE, Hannafin JA, Hewett TE, Huston LJ, et al. Understanding and preventing noncontact anterior cruciate ligament injuries: a review of the Hunt Valley II Meeting. 2005. pp. 1512–1532.

https://pubmed.ncbi.nlm.nih.gov/16905673/

3. Bates NA, McPherson AL, Rao MB, Myer GD, Hewett TE. Characteristics of inpatient anterior cruciate ligament reconstructions and concomitant injuries. Knee Surg Sports Traumatol Arthrosc. 2014:Epub ahead of print.

https://pubmed.ncbi.nlm.nih.gov/25510363/

4. Eberhardt C, Jäger A, Schwetlick G, Rauschmann MA. [History of surgery of the anterior cruciate ligament] Orthopade. 2002;31:702–709

https://pubmed.ncbi.nlm.nih.gov/12426748/

5. Zysk SP, Refior HJ. Operative or conservative treatment of the acutely torn anterior cruciate ligament in middle-aged patients. A follow-up study of 133 patients aged 40 and 59 years. Arch Orthop Trauma Surg. 2000;120:59–64.

https://pubmed.ncbi.nlm.nih.gov/10653106/

6. Herbort M, Lenschow S, Fu FH, Petersen W, Zantop T. ACL mismatch reconstructions: influence of different tunnel placement strategies in single-bundle ACL reconstructions on the knee kinematics. Knee Surg Sports Traumatol Arthrosc. 2010;18:1551–1558.

https://pubmed.ncbi.nlm.nih.gov/20461359/

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