ACL Knee Brace Halifax - The road to recovery

One of the most common knee injuries, particularly in high demand sports, is to the anterior cruciate ligament, more commonly known by its acronym, ACL . A serious injury, damage to the ACL can have a huge impact on our knee’s stability and our ability to return to physical activity.  Early intervention and rehabilitation (such as the use of an ACL knee brace), as well as understanding the steps to take,  are vital to getting you back in the game!

What is an ACL tear?

The anterior cruciate ligament (ACL) is one of four ligaments in the knee. The ACL connects the thigh bone (femur) to the shin bone (tibia) through the center of the knee joint.  Its main functions are:

  • to provide stability for the knee joint, particularly in rotational movements
  • to control the forward motion of the tibia, preventing it from sliding too far forward

Complete ACL tears are, most often, sports-related injuries in high-demand sports,  High-demand sports involve movements that require an intact ACL, like landing jumps, pivoting and quick changes in speed and direction. Sports like basketball, football, soccer and skiing, are considered high-demand. Interestingly, the majority of sports-related ACL tears are non-contact injuries.

ACL tears are not limited to sport. Other potential mechanisms include falls, work-related injuries and motor vehicle collisions, or any other activity that could involve sudden stopping, pivoting or jumps.

Signs & Symptoms

Symptoms you may experience at the time of injury, or in the early period after include:

  • an audible ‘pop’ at the moment of injury
  • instability, a sensation of ‘giving out’
  • swelling
  • pain
  • decreased range of motion (ROM) and difficulty weight bearing

Some of these symptoms may resolve in the weeks after your injury and you may feel the knee is better, however, some symptoms, particularly the shifting and instability, may persist. Repeated stress on the ACL, like recurrent episodes of instability , can create further damage to other parts of the knee, including the cartilage and other ligaments. It is a good idea to consult with a physician prior to returning to physical activity if you feel you may have an ACL injury.

Diagnosing an ACL tear

A physician will be able to perform a complete physical examination on the knee and, using special techniques and tests, may be able to identify an ACL tear.  They may use diagnostic imaging to identify any structural damage in the knee. X-rays may be ordered to rule out injury to the bone and an MRI will likely be ordered to see the soft tissues and identify an ACL tear and any associated damage (ie. meniscal tear, etc.).

If it is believed you have sustained an ACL injury, your treating physician will likely refer you to an orthopedic surgeon. A consultation with an orthopedic surgeon will help you make an informed decision on whether to manage your ACL tear surgically or not. Wait times are difficult to estimate and can depend on many factors, but you can wait anywhere from 3-12 months for an initial consultation with the surgeon.

Do I need surgery?

An ACL tear will not ‘heal’’ once torn, as the ACL cannot repair itself. Surgical reconstruction is required to restore the ligament to its pre-injury state. ACL reconstruction is not necessarily indicated for everyone with an ACL tear. A nonsurgical approach may be effective for certain patients, depending on a variety of factors, like the amount of instability in the knee and the level of physical activity the patient wishes to return to. Should you choose, or be a candidate for, nonsurgical management of your ACL injury, you will still need to commit to a rehabilitation program that will help you regain your pre-injury function. You may be limited to low-demand activities, or a custom knee brace made be indicated for more intense physical activity.

Should you decide to proceed with ACL reconstruction surgery, here is a look at some things to expect through the process.

ACL Reconstruction Surgery: Before & After

Preoperative Care

From the date of initial injury, straight through to your surgery date, there are a few treatment options that can help manage the symptoms of an ACL tear.

Physiotherapy: Whether you are a surgical patient or not, physiotherapy is a vital part of the rehabilitation process. Preoperatively, the goals with physiotherapy are to strengthen the muscles that support the knee, achieve a full ROM and maintain fitness. This will prepare you for managing the postoperative rehabilitation program.

ACL Knee Brace:  A custom acl knee brace is a useful tool to have pre-operatively. It is a functional, rigid frame knee brace that provides stability to the knee for activities of daily living, particularly in rotational movements. It can be worn to support the knee and limit risk of instability episodes leading up to surgery.

Kneehab XP: This neuromuscular electrical stimulation (NMES) device is used in conjunction with your physiotherapy program to help strengthen the quadriceps muscles. This acts to improve strength and stability in the knee.

Day of Surgery

ACL reconstruction surgery is typically a day surgery done arthroscopically. Arthroscopy is a less invasive procedure with a small camera (arthroscope) through small incisions. Arthroscopy can mean less time spent in hospital and reduced recovery times. Because the ACL does not regenerate and cannot simply be sewn back together, a tissue graft is used to reconstruct the ligament. Depending on whether or not you have any associated damage in the knee, the procedure can be approximately 1-2 hours long.

Postoperative Care

In the weeks and months after surgery, your orthopedic surgeon will have you following  an extensive rehabilitation protocol. Your physiotherapy should typically begin within 7-10 days of surgery and will be progressive, with you passing through phases as you reach certain landmarks in your recovery.  There are also a number of products that are used to assist in your recovery.

Post-Op ACL Knee Brace: Often put on immediately following surgery, a post-op knee brace is a controlled ROM (Range of Motion) brace. It can be locked into a straight leg position to immobilize, but can also be adjusted to allow limited ROM as you progress through your protocol. This acl brace is typically worn for 2 weeks, or until you can fit back into your custom knee brace.

Cold Therapy: A cold therapy device is a convenient, easy to use product that provides prolonged cooling to the knee. By reducing inflammation in the knee, the goal is to significantly reduce swelling, aid in pain management and improve patient recovery times.

Kneehab XP: Used again after surgery and in conjunction with physiotherapy, this NMES device has been proven effective in accelerating recovery in ACL reconstruction patients.

Custom Knee Brace: The custom knee brace you wore pre-operatively is a vital part of your rehab. As soon as you are able to fit back into it, you will be able to part with the post-op brace and use your custom brace daily. You will wear the brace for at least the first 12 months following surgery, which will protect the graft and stabilize the knee.

After ACL reconstruction surgery, your surgeon will follow your progress closely, usually seeing you 2 weeks after surgery and then again in specific intervals for up to 12 months. It can take the graft up to 6 months to secure and full ROM, muscle strength and balance may not return until up to 12 months.  It can take up to 24 months to regain maximum function and preinjury condition.

Patients who undergo ACL reconstruction have a good long-term prognosis. Care should be taken to minimize risks of repeat injury by maintaining strength and conditioning  of the supporting muscles and educating yourself on proper techniques for movements that stress the ACL.

If you have a torn ACL and require an ACL knee brace or an orthopedic consultation, please contact us today.

Written by:
Emily Ingraham
Orthopedic Bracing Specialist
Arthritis & Injury Care Centre

2024 © Copyright - Arthritis & Injury Care Centre

Toll Free: (888) 422-1608