What is a grade 2 ligament tear

How ACL and PCL violations differ

Medicine 2021

The anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) are two main ligaments in the knee that work together to ensure stability. he are also frequent places of heavy wear

Content:

The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are two main ligaments in the knee that work together to provide stability. They are also common places of heavy tears, especially among athletes.

Although ACL and PCL injuries may initially have similar symptoms, such as knee instability and pain, the ligaments have unique properties that differentiate them in terms of subject, extent of injury, and treatment guidelines.

anatomy

ACL and PCL are two main ligaments that cross in the joint and allow the knee to bend and straighten without sliding back and forth. The ACL prevents the tibia from sliding forward along the femur, while the PCL prevents the tibia and femur from sliding backward.

Together, they provide stability to the knee joint and prevent it from moving from side to side while allowing it to bend and stretch at the same time. The ACL prevents the tibia from sliding forward along the femur, while the PCL prevents the tibia and femur from sliding towards each other.

The other two ligaments of the knee, the medial collateral ligament (MCL) and the lateral collateral ligament (LCL). These run along the outside of the knee and prevent the knee from bending sideways.

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Symptoms

The symptoms of ACL injury and PCL injury are essentially the same: pain, swelling, and knee instability. Where they tend to differ is the extent of the injury and the severity of the symptoms.

Because the ACL is smaller and weaker than the PCL, it is more likely to suffer a complete tear. In this case, an audible "bang" can occur the moment the tape breaks. ACL damage can extend to adjacent structures, including other ligaments, as well as the crescent-shaped cartilage cushion known as the meniscus, which acts as a cushion between the bottom of the femur and the top of the tibia.

The pain with an ACL tear is usually more severe than with a PCL tear. There can also be a significant (or complete) loss of freedom of movement of the knee. The swelling from an ACL tear develops slowly over 24 hours.

Most PCL injuries are partial tears. Swelling is likely to appear almost immediately, but there is relatively less pain, if at all. Less than 20% of knee ligament injuries involve PCL.

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causes

Both ACL cracks and PCL cracks can result from a sports accident. The ACL is most likely to be injured from a sudden stop or rapid change in directional movements typical of activities such as soccer, basketball, soccer, and skiing. An awkward landing after a jump can also damage the ACL. The risk of a sport-related cruciate ligament tear is increased in people who are in poor physical condition, have poorly fitting shoes (or ski bindings), and play on slippery artificial turf.

Being a woman is also a risk factor for ACL tears. Women athletes are two to seven times more likely than men to injure their ACL due to a number of anatomical and biomechanical differences between the two sexes.

PCL cracks usually appear when the knee is flexed, e.g. B. in a fall with the knee pointing downwards or in a car accident in which the bent knee is trapped in the dashboard. A hard blow to the shin just below the knee, such as can occur in soccer or football, can injure the PCL, as can a misstep on an uneven surface.

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diagnosis

To diagnose a ruptured ACL or PCL, a doctor begins with a physical exam that looks for certain signs and symptoms of an injury.

With a cruciate ligament rupture, the knee feels tender along the joint line and it is difficult, if not impossible, to bend the knee. There may also be cramps and thigh muscle protection in the back of the thigh.

A tell-tale sign of a PCL tear is a posterior, sagging position of the knee when flexing. The kneecap may slide back further if the knee is bent more than 90 degrees.

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Once a tear is suspected, the diagnosis can be confirmed with an x-ray (which can show complete tears) or magnetic resonance imaging (which makes ligaments and other soft tissues more visible).

treatment

Treatment for ACL and PCL injuries is essentially the same, but depends on the severity or degree of the injury:

  • 1st Class: The band is slightly stretched, but the knee is stable.
  • Grade 2: The tape has become loose or partially torn.
  • 3rd grade: The ligament is completely torn.

Depending on the degree, the injury can be treated using the RICE protocol: rest, ice, compression, and altitude. Physiotherapy is often recommended to restore joint strength and range of motion. Complete tears can require arthroscopic surgery and ligament reconstruction.

The only real difference between treating ACL and PCL injuries is the likelihood of surgery. Because ACL cracks are more likely to be complete, the course of treatment tends to be far more extensive.

Not everyone with a complete ACL rupture needs surgery. People who are largely inactive or elderly can often get by with a knee brace or assisted mobility device after an ACL tear.

On the other hand, most PCL injuries can heal on their own without surgery and may only require crutches and a knee immobilizer to prevent knee movement during recovery.

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